U.S. patent application number 11/340352 was filed with the patent office on 2007-01-18 for system and method for collecting, organizing, and presenting visit-oriented medical information.
Invention is credited to Richard Stroup.
Application Number | 20070016441 11/340352 |
Document ID | / |
Family ID | 37662755 |
Filed Date | 2007-01-18 |
United States Patent
Application |
20070016441 |
Kind Code |
A1 |
Stroup; Richard |
January 18, 2007 |
System and method for collecting, organizing, and presenting
visit-oriented medical information
Abstract
A method and computer program collects patients' medical
information and presents the information to a user via an
interactive user interface (400) that includes a plurality of
information tabs. Each tab presents information about a particular
patient from a certain phase of the patient's visit to a healthcare
providing facility. The information tabes include diagnoses (402),
heart lab (404), radiology (406), pre-operative (408), operative
(410), post-operative (412), reports (414), discharge (416), and
follow up (418). The post-operative tab presents laboratory test
results in the form of a table (514) and a chart (516), wherein the
chart includes laboratory test results graphed over time and
corresponding event and normal value indicators.
Inventors: |
Stroup; Richard; (Overland
Park, KS) |
Correspondence
Address: |
HOVEY WILLIAMS LLP
2405 GRAND BLVD., SUITE 400
KANSAS CITY
MO
64108
US
|
Family ID: |
37662755 |
Appl. No.: |
11/340352 |
Filed: |
January 26, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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60694160 |
Jun 27, 2005 |
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Current U.S.
Class: |
705/2 |
Current CPC
Class: |
G16H 10/60 20180101;
G16H 20/40 20180101; G16H 20/10 20180101; G16H 15/00 20180101; G16H
30/20 20180101; G16H 10/40 20180101; G06Q 10/10 20130101 |
Class at
Publication: |
705/002 |
International
Class: |
G06Q 10/00 20060101
G06Q010/00 |
Claims
1. A computer-readable medium encoded with a computer program for
organizing and presenting patient information, the computer program
comprising: a communications code segment for establishing a
communications link with a laboratory information system and a
hospital information system; a post-operative code segment for
receiving from the laboratory information system a plurality of
laboratory test results pertaining to a user-selected patient, and
for concurrently presenting a table with the laboratory test
results and a chart visually illustrating at least one laboratory
test result over time; and a reports code segment for presenting a
list of medical reports relating to the patient, retrieving from
the hospital information system a report selected by a user, and
presenting the report to the user.
2. The computer-readable medium as set forth in claim 1, wherein
the post-operative code segment is operable to present an event
indicator on the chart concurrently with the lab result, wherein
the event indicator is placed to visually correspond to a lab
result taken at the time of the event.
3. The computer-readable medium as set forth in claim 1, wherein
the post-operative code segment is operable to present on the chart
a visual indicator of a normal range of the test result illustrated
in the chart.
4. The computer-readable medium as set forth in claim 1, wherein
the program further comprises an imaging code segment for
establishing a communications link with a hospital imaging system,
presenting a user interface generated by the hospital imaging
system, and enabling a user to interact with the hospital imaging
system via the user interface.
5. A computer-readable medium encoded with a computer program for
organizing and presenting patient information, the computer program
comprising: an operative code segment for presenting information
about surgeries performed during a visit of a user-selected
patient; a post-operative code segment for concurrently presenting
a list of the patient's laboratory test results in chronological
order and a chart for visually illustrating at least one lab result
over time; an events code segment for concurrently presenting a
table of all events relating to the patient and a plurality of
tables each listing a particular category of events; a vital signs
code segment for concurrently presenting a ventilator table with
ventilator setting and measurement information, a weight table with
patient weight information, and a temperature table with patient
temperature information; and a reports code segment for presenting
a list of medical reports relating to the patient, and for
retrieving a report selected by a user from a hospital information
system and presenting the report to the user.
6. The computer-readable medium as set forth in claim 5, wherein
the post-operative code segment is operable to present an event
indicator on the chart concurrently with the lab result, wherein
the event indicator is placed to visually correspond to a lab
result taken at the time of the event.
7. The computer-readable medium as set forth in claim 6, wherein
the event indicator represents an event selected by the user from
the table of events.
8. The computer-readable medium as set forth in claim 5, wherein
the post-operative code segment is operable to present on the chart
a visual indicator of a normal range of the test result illustrated
in the chart.
9. The computer-readable medium as set forth in claim 5, wherein
the computer program further comprises an imaging code segment for
establishing a link to a hospital imaging system, presenting a user
interface generated by the hospital imaging system, and enabling
the user to interact with the hospital imaging system via the user
interface.
10. The computer-readable medium as set forth in claim 9, wherein
the hospital imaging system is chosen from the group consisting of
a cardiology imaging system that presents catheterization and echo
image study information and a radiology imaging system that
presents radiology image study information.
11. The computer-readable medium as set forth in claim 5, wherein
the operative code segment presents information relating to
diagnoses, procedures, complications, valves, homografts,
perfusion, and anesthesiology.
12. The computer-readable medium as set forth in claim 5, wherein
the post-operative code segment presents a plurality of laboratory
test result lists, wherein a first list relates to blood gas
laboratory tests, a second list relates to hematology laboratory
tests, a third list relates to coagulation laboratory tests, and a
fourth list relates to chemistry laboratory tests.
13. The computer-readable medium as set forth in claim 12, wherein
each test result includes an indication received from the
laboratory of whether the result is normal, abnormally high, or
abnormally low.
14. The computer-readable medium as set forth in claim 5, wherein
the categories of events include medications, movements, pulmonary,
procedures, and complications.
15. The computer-readable medium as set forth in claim 5, wherein
the post operative code segment presents a table listing
endocrinology laboratory results for the patient, wherein each
laboratory result includes an indication received from the
laboratory of whether the result is normal, abnormally high, or
abnormally low.
16. The computer-readable medium as set forth in claim 5, wherein
the post operative code segment presents a table listing liver
profile laboratory results for the patient, wherein each liver
profile result includes an indication received from the laboratory
of whether the result is normal, abnormally high, or abnormally
low.
17. The computer-readable medium as set forth in claim 5, wherein
the post operative code segment presents a table listing urinalysis
laboratory results for the patient, wherein each urinalysis result
includes an indication received from the laboratory of whether the
result is normal, abnormally high, or abnormally low.
18. The computer-readable medium as set forth in claim 5, wherein
the post operative code segment presents a table listing laboratory
test results for the patient that are otherwise presented by the
post operative code segment, wherein each result of the other tests
window includes a test category, a result type, a result, and an
indication received from the laboratory of whether the result is
normal, abnormally high, or abnormally low.
19. The computer-readable medium as set forth in claim 5, wherein
the post operative code segment presents a table including patient
intakes and outputs and a chart including a visual illustration of
one or more ins and outs values over time, wherein the chart values
include a balance of ins and outs for a twelve-hour period and a
thirty-six hour moving average calculated by averaging three
consecutive twelve-hour balance values.
20. The computer-readable medium as set forth in claim 5, wherein
the program further comprises a lab interface code segment for
establishing an interface with a hospital computer system that
maintains laboratory test result information, wherein the lab
interface code segment receives the patient's laboratory test
results used by the post operative code segment.
21. The computer-readable medium as set forth in claim 5, wherein
the computer program further comprises a communications code
segment for establishing a communications link with a laboratory
information system and receiving the patient's laboratory test
results from the laboratory information system.
22. A computer-readable medium encoded with a computer program for
organizing and presenting patient information, the computer program
comprising: a pre-operative code segment for presenting a
pre-operative data sheet for a user-selected patient; an imaging
code segment for establishing links with two or more different
medical imaging systems and presenting a user interface generated
by one of the imaging systems selected by the user, wherein the
user can interact with the selected imaging system via the user
interface; an operative code segment for presenting a chronological
list of surgeries performed on a user-selected patient during a
user-selected visit of the patient, and for presenting detailed
information about a surgery selected by the user from the list of
surgeries, wherein the detailed information includes diagnoses,
procedures, complications, valves, homografts, perfusion, and
anesthesiology; a post-operative code segment for creating a
plurality of windows each presenting concurrently a test result
table including a plurality of laboratory test results and a
laboratory test result chart including a visual illustration of at
least one of the laboratory test results plotted over time, wherein
a first window relates to blood gas laboratory tests, a second
window relates to hematology laboratory tests, a third window
relates to coagulation laboratory tests, and a fourth window
relates to chemistry laboratory tests, and wherein at least one of
the test results includes an indication received from the
laboratory of whether the result is normal, abnormally high, or
abnormally low; an events code segment for concurrently presenting
an event timeline table and a plurality of event category tables,
wherein the event timeline table includes a date, time, category,
general description and detailed description of each event, and
wherein each event category table presents a date, time, general
description and detailed description of each event within the
category, and the categories include medications, movements,
pulmonary, procedures, and complications; a vital signs code
segment for concurrently presenting a ventilator table with
ventilator setting and measurement information, a weight table
listing all weight measurements of the patient recorded during the
visit, and a temperature table listing all temperatures of the
patient recorded during the visit, wherein the code segment
automatically adds a new ventilator table entry each time a blood
gas lab result is received and enables a user to fill the new row
with ventilator information; and a reports code segment for
presenting a list of medical reports stored in the hospital
information system and relating to the patient, and for presenting
a report selected by the user by requesting a copy of the report
from the hospital information system and presenting the copy to the
user, wherein the list of medical reports is selectively presented
according to department or report date.
23. The computer-readable medium as set forth in claim 22, wherein
the post operative code segment further creates an endocrinology
tab that presents a table listing endocrinology laboratory results
for the patient, wherein each laboratory result includes an
indication received from the laboratory of whether the result is
normal, abnormally high, or abnormally low.
24. The computer-readable medium as set forth in claim 22, wherein
the post operative code segment further creates a liver profile tab
that presents a table listing liver profile laboratory results for
the patient, wherein each liver profile result includes an
indication received from the laboratory of whether the result is
normal, abnormally high, or abnormally low.
25. The computer-readable medium as set forth in claim 22, wherein
the post operative code segment further creates a urinalysis tab
that presents a table listing urinalysis laboratory results for the
patient, wherein each urinalysis result includes an indication
received from the laboratory of whether the result is normal,
abnormally high, or abnormally low.
26. The computer-readable medium as set forth in claim 22, wherein
the post operative code segment further creates an other tests tab
that presents a table listing laboratory test results for the
patient that are not otherwise presented by the post operative code
segment, wherein each result of the other tests window includes a
test category, a result type, a result, and an indication received
from the laboratory of whether the result is normal, abnormally
high, or abnormally low.
27. The computer-readable medium as set forth in claim 22, wherein
the post operative code segment further creates an ins and outs tab
that concurrently presents a table including patient intakes and
outputs and a chart including a visual illustration of one or more
ins and outs values over time, wherein the chart values include a
balance of ins and outs for a twelve-hour period and a thirty-six
hour moving average calculated by averaging three consecutive
twelve-hour balance values.
28. The computer-readable medium as set forth in claim 22, wherein
the two or more hospital imaging systems include a cardiology
imaging system that presents catheterization and echo image study
information and a radiology imaging system that presents cardiology
image study information.
29. The computer-readable medium as set forth in claim 22, wherein
the post-operative code segment is operable to present an event
indicator on each chart concurrently with a lab test result,
wherein the event is placed to visually correspond to the lab test
result received at the time of the event.
30. The computer-readable medium as set forth in claim 29, wherein
the event indicator corresponds to an event selected by the user
from the table of events.
31. The computer-readable medium as set forth in claim 22, wherein
the post-operative code segment is operable to present on each
chart a visual indicator of a normal range of the test result
illustrated in the chart.
32. The computer-readable medium as set forth in claim 22, wherein
the computer program further comprises a communications code
segment for establishing a communications link with a laboratory
information system and receiving the patient's laboratory test
results from the laboratory information system.
Description
RELATED APPLICATIONS
[0001] The present application is a nonprovisional patent
application and claims priority benefit, with regard to all common
subject matter, of earlier-filed U.S. provisional patent
application titled "SYSTEM AND METHOD OF COLLECTING, ORGANIZING,
AND ANALYZING MEDICAL INFORMATION", Ser. No. 60/694,160, filed Jun.
27, 2005. The identified earlier-filed application is hereby
incorporated by reference into the present application.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] The present invention relates to the field of
computer-assisted collection, organization, and presentation of
medical information. More particularly, the invention relates to a
method and computer program for collecting, organizing and
presenting information from various phases of a patient's visit to
a health providing facility such that a user can quickly select a
patient and view or modify the information pertaining to the
patient.
[0004] 2. Description of the Prior Art
[0005] Doctors, nurses, and other care givers often work with a
large number of patients and collect a significant amount of
medical information relating to each patient. Such medical
information may include, for example, laboratory test results,
surgical procedure data, physician's notes, and medical images.
[0006] Computer programs and systems have been developed to assist
in the collection and storage of patient medical information. For
example, hospital information systems (HIS) are currently used by
hospitals to store and retrieve information relating to the
administrative and clinical aspects of the hospital's services.
Furthermore, laboratory information systems and a hospital imaging
systems assist caregivers in the management of laboratory data and
medical images, respectively.
[0007] Prior art systems of managing medical information enable
caregivers to store and retrieve information relating to a
particular patient. Unfortunately, however, these systems suffer
from various problems and limitations. For example, users must
access two or more different systems to obtain the information
created by each system, and are limited to retrieving and viewing
information relating to a single patient at a time.
[0008] Accordingly, there is a need for an improved system and
method of collecting, organizing, and presenting patient
information.
SUMMARY OF THE INVENTION
[0009] The present invention solves the above-described problems
and provides a distinct advance in the art of medical information
software. More particularly, the present invention involves a
method and computer program for collecting, organizing and
presenting information from various phases of a patient's visit to
a health providing facility such that a user can quickly select a
patient and view or modify the information pertaining to the
patient.
[0010] According to a first embodiment of the invention, the
computer program runs on a standard personal computer (PC) or
similar device and comprises a communications code segment, a
post-operative code segment, and an imaging code segment.
[0011] The communications code segment establishes a communications
link with a laboratory information system and a hospital
information system. The post-operative code segment receives from
the laboratory information system a plurality of laboratory test
results pertaining to a user-selected patient, and concurrently
presents a table with the laboratory test results and a chart
visually illustrating at least one laboratory test result over
time. The reports code segment presents a list of medical reports
relating to the patient and retrieves from the hospital information
system a report selected by a user presents the report to the
user.
[0012] In a second embodiment of the invention, the program
comprises a plurality of code segments, including an operative code
segment for presenting information about surgeries performed during
a visit of a user-selected patient. A post-operative code segment
concurrently presents a list of the patient's laboratory test
results in chronological order and a chart for visually
illustrating at least one lab result over time. An events code
segment concurrently presents a table of all events relating to the
patient and a plurality of tables each listing a particular
category of events.
[0013] A vital signs code segment concurrently presents a
ventilator table with ventilator setting and measurement
information, a weight table with patient weight information, and a
temperature table with patient temperature information. A reports
code segment presents a list of medical reports relating to the
patient, and retrieves a report selected by a user from a hospital
information system and presenting the report to the user.
[0014] In a third embodiment of the invention the program comprises
a pre-operative code segment for presenting a pre-operative data
sheet for a user-selected patient, and an imaging code segment for
establishing links with two or more different medical imaging
systems. The imaging code segment further presents a user interface
generated by one of the imaging systems selected by the user,
wherein the user can interact with the selected imaging system via
the user interface.
[0015] The program further comprises an operative code segment for
presenting a chronological list of surgeries performed on a
user-selected patient during a user-selected visit of the patient,
and for presenting detailed information about a surgery selected by
the user from the list of surgeries. Such detailed information may
include diagnoses, procedures, complications, valves, homografts,
perfusion, and anesthesiology. A post-operative code segment
creates a plurality of windows each presenting concurrently a test
result table including a plurality of laboratory test results and a
laboratory test result chart including a visual illustration of at
least one of the laboratory test results plotted over time. A first
window relates to blood gas laboratory tests, a second window
relates to hematology laboratory tests, a third window relates to
coagulation laboratory tests, and a fourth window relates to
chemistry laboratory tests. At least one of the test results
includes an indication received from the laboratory of whether the
result is normal, abnormally high, or abnormally low.
[0016] An events code segment concurrently presents an event
timeline table and a plurality of event category tables. The event
timeline table includes a date, time, category, general description
and detailed description of each event, and each event category
table presents a date, time, general description and detailed
description of each event within the category. Exemplary categories
include medications, movements, pulmonary, procedures, and
complications.
[0017] A vital signs code segment concurrently presents a
ventilator table with ventilator setting and measurement
information, a weight table listing all weight measurements of the
patient recorded during the visit, and a temperature table listing
all temperatures of the patient recorded during the visit. The
vital signs code segment automatically adds a new ventilator table
entry each time a blood gas lab result is received and enables a
user to fill the new row with ventilator information.
[0018] A reports code segment presents a list of medical reports
stored in the hospital information system and relating to the
patient, and presents a report selected by the user by requesting a
copy of the report from the hospital information system and
presenting the copy to the user. The list of medical reports is
selectively presented according to department or report date.
[0019] These and other important aspects of the present invention
are described more fully in the detailed description below.
BRIEF DESCRIPTION OF THE DRAWING FIGURES
[0020] A preferred embodiment of the present invention is described
in detail below with reference to the attached drawing figures,
wherein:
[0021] FIG. 1 is a schematic view of an exemplary computer network
for implementing the present invention;
[0022] FIG. 2 is a schematic view of the interconnection between a
computer of the network of FIG. 1 and various databases and systems
of the network;
[0023] FIG. 3 is a top-level user interface associated with a
department view of the present invention presenting a plurality of
activity windows;
[0024] FIG. 4 is the user interface of FIG. 3 illustrated with
context menus that are associated with various of the activity
windows;
[0025] FIG. 5 is a procedure form presented when the user selects a
view procedure menu item of a context menu associated with a
procedures activity window;
[0026] FIG. 6 is an add patient form presented when the user
selects an add patient to rounds menu item of a context menu
associated with a rounds activity window;
[0027] FIG. 7 is an add notes form presented when the user selects
an add/edit round notes menu item of the context menu associated
with the rounds activity window;
[0028] FIG. 8 is an add rounds miscellaneous form presented when
the user selects an add/edit round miscellaneous menu item of the
context menu associated with the rounds activity window;
[0029] FIG. 9 is a rounds report created when the user selects a
create rounds report menu item of the context menu associated with
the rounds activity window;
[0030] FIG. 10 is a filter by form presented when the user selects
a filter by menu item from any of the activity windows of the
interface of FIG. 3;
[0031] FIG. 11 is a top-level user interface associated with a
patient view of the present invention and illustrating a medical
history tab of the interface;
[0032] FIG. 12 is the user interface of FIG. 11 illustrated with
context menus that are associated with various information windows
of the user interface;
[0033] FIG. 13 is a new-appointment form presented by the computer
when the user selects an "add new appointment and surgery" menu
item from a context menu associated with a scheduled visits
information window of the interface of FIG. 3;
[0034] FIG. 14 is an exemplary heart lab tab of the user interface
of FIG. 11;
[0035] FIG. 15 is an echocardiogram web interface presented as part
of the heart lab tab of FIG. 14;
[0036] FIG. 16 is an exemplary radiology tab of the user interface
of FIG. 11;
[0037] FIG. 17 is an exemplary radiology web interface presented as
part of the radiology tab of FIG. 16;
[0038] FIG. 18 is an exemplary demographics tab of the user
interface of FIG. 11;
[0039] FIG. 19 is an exemplary studies tab of the user interface of
FIG. 11;
[0040] FIG. 20 is an exemplary top-level user interface associated
with a visit view of the present invention and illustrating an
operative tab of the interface;
[0041] FIG. 21 is the interface of FIG. 20 illustrating another
aspect of the operative tab;
[0042] FIG. 22 is the interface of FIG. 20 illustrating a blood
gases element of a post-operative tab of the interface;
[0043] FIG. 23 is an exemplary table of laboratory test results
that may be presented in the blood gases element of the
post-operative tab of FIG. 22;
[0044] FIG. 24 is the interface of FIG. 22, illustrating a
hematology element of the post-operative tab;
[0045] FIG. 25 is a table of exemplary laboratory test results that
may be presented in the hematology element of the post-operative
tab of FIG. 24;
[0046] FIG. 26 is the interface of FIG. 22 illustrating a
coagulation element of the post-operative tab;
[0047] FIG. 27 is a table of exemplary laboratory test results that
may be presented in the coagulation element of the post-operative
tab of FIG. 26;
[0048] FIG. 28 is the interface of FIG. 22 illustrating a chemistry
element of the post-operative tab;
[0049] FIG. 29 is a table of exemplary laboratory test results that
may be presented in the chemistry element of the post-operative tab
of FIG. 28;
[0050] FIG. 30 is the interface of FIG. 22 illustrating an
endocrinology element of the post-operative tab;
[0051] FIG. 31 is the interface of FIG. 22 illustrating a liver
profile element of the post-operative tab;
[0052] FIG. 32 is a table of exemplary laboratory test results that
may be presented in the liver profile element of the post-operative
tab of FIG. 31;
[0053] FIG. 33 is the interface of FIG. 22 illustrating a
urinalysis element of the post-operative tab;
[0054] FIG. 34 is a table of exemplary laboratory test results that
may be presented in the urinalysis element of the post-operative
tab of FIG. 33;
[0055] FIG. 35 is the interface of FIG. 22 illustrating an "other
tests" element of the post-operative tab;
[0056] FIG. 36 is the interface of FIG. 22 illustrating an "ins
& outs" element of the post-operative tab of the interface;
[0057] FIG. 37 is a table of exemplary laboratory test results that
may be presented in the ins & outs element of the
post-operative tab of FIG. 36;
[0058] FIG. 38 is an exemplary data entry form for submitting
intake and output information associated with the ins & outs
element of FIG. 36;
[0059] FIG. 39 is the interface of FIG. 22 illustrating an events
element of the post-operative tab;
[0060] FIG. 40 is an exemplary data entry form for submitting event
information associated with the events element of FIG. 39;
[0061] FIG. 41 is the interface of FIG. 22 illustrating a vital
signs element of the post-operative tab;
[0062] FIG. 42 is an exemplary data entry form for submitting
ventilatory information associated with the vital signs element of
FIG. 41;
[0063] FIG. 43 is an exemplary data entry form for submitting
patient weight information associated with the vital signs element
of FIG. 41;
[0064] FIG. 44 is an exemplary data entry form for submitting
patient body temperature information associated with the vital
signs element of FIG. 41;
[0065] FIG. 45 is the interface of FIG. 20 illustrating a reports
tab of the user interface;
[0066] FIG. 46 is the interface of FIG. 45 illustrating a report
generated by the program and presented via the reports tab;
[0067] FIG. 47 is an exemplary top-level user interface associated
with a research view of the present invention and illustrating a
study setup tab of the interface;
[0068] FIG. 48 is the interface of FIG. 47 illustrating a members
tab of the interface;
[0069] FIG. 49 is an exemplary data entry form for selecting a
member to add to a list of study members of the members tab of FIG.
47;
[0070] FIG. 50 is the interface of FIG. 47 illustrating a patients
tab of the interface;
[0071] FIG. 51 is an exemplary data entry form for submitting
patient enrollment date information associated with the patients
tab of FIG. 50;
[0072] FIG. 52 is an exemplary form that presents identification
information about patients participating in a study associated with
the interface of FIG. 47;
[0073] FIG. 53 is the interface of FIG. 47 illustrating a comments
tab of the interface;
[0074] FIG. 54 is an exemplary form for submitting comment
information associated with the comments tab of FIG. 53;
[0075] FIG. 55 is the interface of FIG. 47 illustrating a
parameters tab of the interface;
[0076] FIG. 56 is the interface of FIG. 3 illustrating various
menus of a interface toolbar;
[0077] FIG. 57 is an exemplary patient search form invoked via the
toolbar of FIG. 56;
[0078] FIG. 58 is an exemplary patient studies form invoked via the
toolbar of FIG. 56, wherein the form presents a list of patient
studies;
[0079] FIG. 59 is the hematology element of FIG. 24 illustrating a
laboratory results chart that simultaneously presents event
indicators and laboratory result graphs;
[0080] FIG. 60 is an exemplary form for submitting event
information associated with the chart of FIG. 59;
[0081] FIG. 61 is an exemplary chart with a normal range
indicator;
[0082] FIG. 62 is an exemplary form for submitting test type and
lab value information associated with the chart of FIG. 61;
[0083] FIG. 63 is a table of exemplary lab tests and lab test types
associated with the form of FIG. 62;
[0084] FIG. 64 is an exemplary run chart illustrating various
laboratory test results plotted before normalization;
[0085] FIG. 65 is the run chart of FIG. 64 illustrating the
laboratory test results plotted after normalization;
[0086] FIG. 66 is an exemplary form for submitting test type and
lab value information associated with the chart of FIG. 65; and
[0087] FIG. 67 is an exemplary form for submitting time period
information associated with data retrieval functions of the
program.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0088] The present invention relates to a system and method of
collecting, organizing, and presenting patients' medical
information. The method of the present Invention is especially
well-suited for implementation on a computer or computer network,
such as the computer 10 illustrated in FIG. 1 that includes a
keyboard 12, a processor console 14, a display 16, and one or more
peripheral devices 18, such as a scanner or printer. The computer
10 may be a part of a computer network, such as the computer
network 20 that includes one or more client computers 10,22 and one
or more server computers 24,26 and interconnected via a
communications system 28. The present invention may also be
implemented, in whole or in part, on a wireless communications
system including, for example, a network-based wireless transmitter
30 and one or more wireless receiving devices, such as a hand-held
computing device 32 with wireless communication capabilities. The
present invention will thus be generally described herein as a
computer program. It will be appreciated, however, that the
principles of the present invention are useful independently of a
particular implementation, and that one or more of the steps
described herein may be implemented without the assistance of a
computing device.
[0089] The present invention can be implemented in hardware,
software, firmware, or a combination thereof. In a preferred
embodiment, however, the invention is implemented with a computer
program. The computer program and equipment described herein are
merely examples of a program and equipment that may be used to
implement the present invention and may be replaced with other
software and computer equipment without departing from the scope of
the present invention.
[0090] The computer program of the present invention is stored in
or on a computer-readable medium residing on or accessible by a
host computer for instructing the host computer to implement the
method of the present invention as described herein. The host
computer may be a server computer, such as server computer 24, or a
network client computer, such as computer 10. The computer program
preferably comprises an ordered listing of executable instructions
for implementing logical functions in the host computer and other
computing devices coupled with the host computer. The computer
program can be embodied in any computer-readable medium for use by
or in connection with an instruction execution system, apparatus,
or device, such as a computer-based system, processor-containing
system, or other system that can fetch the instructions from the
instruction execution system, apparatus, or device, and execute the
instructions.
[0091] The ordered listing of executable instructions comprising
the computer program of the present invention will hereinafter be
referred to simply as "the program" or "the computer program." It
will be understood by those skilled in the art that the program may
comprise a single list of executable instructions or two or more
separate lists, and may be stored on a single computer-readable
medium or multiple distinct media. The program will also be
described as comprising various "code segments," which may include
one or more lists, or portions of lists, of executable
instructions. Code segments may include overlapping lists of
executable instructions-that is, a first code segment may include
instruction lists A and B, and a second code segment may include
instruction lists B and C.
[0092] In the context of this application, a "computer-readable
medium" can be any means that can contain, store, communicate,
propagate or transport the program for use by or in connection with
the instruction execution system, apparatus, or device. The
computer-readable medium can be, for example, but not limited to,
an electronic, magnetic, optical, electromagnetic, infrared, or
semi-conductor system, apparatus, device, or propagation medium.
More specific, although not inclusive, examples of the
computer-readable medium would include the following: an electrical
connection having one or more wires, a portable computer diskette,
a random access memory (RAM), a read-only memory (ROM), an
erasable, programmable, read-only memory (EPROM or Flash memory),
an optical fiber, and a portable compact disk read-only memory
(CDROM). The computer-readable medium could even be paper or
another suitable medium upon which the program is printed, as the
program can be electronically captured, via for instance, optical
scanning of the paper or other medium, then compiled, interpreted,
or otherwise processed in a suitable manner, if necessary, and then
stored in a computer memory.
[0093] Referring to FIG. 2, the program is operable to communicate
with various pre-existing, computer-based hospital information and
imaging systems to request and receive patient-related and other
medical and research information and present the information on the
host computer as a single point of information access. The computer
10 may communicate, for example, with a hospital information system
(HIS) 20a; a radiology imaging system 20b; a cardiology imaging
system 20c; a laboratory and operating room information system 20d;
and a local database 20e. The HIS 20a is a computer-assisted system
designed to store, manipulate and retrieve information concerned
with the administrative and clinical aspects of providing services
within the hospital. An exemplary HIS is sold by MEDICAL
INFORMATION TECHNOLOGY, INC..TM. The radiology imaging system 20b
manages radiological images, and an exemplary radiology imaging
system is SYNAPSE.TM. sold by FUJIFILM MEDICAL SYSTEMS USA,
INC..TM. The cardiology imaging system 20c is similar to the
radiology imaging system 20b, except that the cardiology imaging
system 20c manages cardiology images. The laboratory and operating
room information system 20d manages laboratory operating room data,
and an exemplary system 20d is sold by MEDITECH.TM..
[0094] If the program of the present invention is implemented on
the first server 24, for example, one or more of the hospital
information and imaging systems may be running on the server 26,
wherein the program communicates with the server 26 via the
communications network 28. The program may also receive all or a
portion of the information directly from users. The program creates
a series of interactive user interfaces for presenting the
information in a user-viewable form and for enabling users to
communicate directly with one or more of the hospital information
and imaging systems. The interactive user interfaces can generally
be classified according to the information presented by each
interface. A group of interfaces that present related information
are collectively referred to herein as a "view." The program
generally presents a department view, a patient view, a visit view,
and a research view, as explained below.
The Department View
[0095] Referring to FIG. 3, the department view presents a
top-level interface 34 that enables physicians, nurses, clinical
care givers and other users to view activities and information
associated with patients and particular groups of patients for a
particular day. The illustrated department view interface 34
includes eight activity windows, wherein each window presents
information according to certain parameters. The illustrated
activity windows include inpatients 36, procedures 38, clinics 40,
daily schedule 42, rounds 44, consults 46, cath conference 48, and
personal notes 50 activity windows. The program preferably presents
the activity windows simultaneously, so that the user can quickly
and easily scan the information presented in each window without
having to navigate multiple user interface pages.
[0096] The department view interface 34 also includes one or more
date selectors 52,54, wherein each date selector enables the user
to quickly choose a date associated with one or more of the
activity windows. The illustrated interface 34 includes two
drop-down calendar date selectors 52,54. A first date selector 52
enables a user to select a date pertaining to the procedures 38,
clinics 40, and daily schedule 42 activity windows. A second
drop-down date selector 54 enables the user to select a date
pertaining to the cath conference activity window 48. When the
department view interface 34 is first presented, the default value
for the first date selector 52 is the current date. The default
value for the second date selector 54 is a pre-determined day of
the week. If catheterization conferences are held on Friday
mornings, for example, the default value for the second date
selector 54 is the Friday following the current date. The user may
then choose another date from either date selector 52,54 to view
events associated with that particular day. The date selectors
52,54 are also presented simultaneously with the activity
windows.
[0097] A menu toolbar 56 is located near a top of the interface 34,
and a specific context menu is associated with each activity window
(see FIG. 4). The menu toolbar 56 enables the user to perform
functions and select items and options that are global in nature
and thus pertain to the department view generally as well as one or
more other views of the program, and are not associated with a
specific activity window. The context menus enable the user to
perform functions and select parameters and options that are
associated with a specific activity window, and to "drill down" to
obtain more detailed information about a selected patient or
activity that is located within a specific activity window. The
context menu associated with each activity window is preferably a
"pop-up" menu activated when the user positions an on-screen
pointer or arrow over the specific activity window and selects a
designated input button, such as a computer mouse button.
The Inpatients Activity Window
[0098] The inpatients activity window 36 presents information about
patients currently admitted to the hospital or to one or more
departments or services of the hospital. Upon admission to the
hospital, each inpatient is assigned a service, a team, and an
attending physician. Patients may be included in the inpatients
activity window 36 while they are admitted to any service of the
hospital, or may be included in the inpatients activity window 36
only upon being assigned to a designated hospital service, group of
services, physician, or group of physicians. Inpatients are
automatically included in the illustrated inpatients activity
window 36 when they are assigned to a particular service or
services, such as cardiovascular surgery or cardiology services, or
are assigned to a physician associated with these services. The
program also automatically removes patients from the window 36 when
they are no longer assigned to one of these services or associated
physicians.
[0099] The program automatically updates the inpatients activity
window 36 by adding patients who are assigned to one of the
designated services or physicians, and by removing patients who are
no longer assigned to one of the designated services or physicians.
These automatic updates occur at a predefined or user-defined
interval, such as every five minutes. The program determines
patients' status by communicating with a hospital information
system, or "HIS," to receive the information as recorded in the
HIS.
[0100] As illustrated, the inpatient activity window 36 presents a
plurality of rows 58 of information, wherein each row 58 pertains
to a particular patient. The illustrated information includes each
patient's full name 60, an attending physician identifier 62
indicating which physician is currently attending the patient, and
a current location 64 of the patient. The physician identifier 62
may be the first four characters of the physician's last name, and
the location information may be a room number.
[0101] An inpatients context menu 66 is illustrated in FIG. 4,
wherein the context menu 66 appears when the user positions the
on-screen pointer over the inpatient activity window 36 and presses
the designated input button, as explained above. The context menu
66 enables users to perform functions and select parameters and
options that are associated with the inpatients activity window 36,
and to drill down to obtain more detailed information about a
selected patient.
[0102] The context menu 66 generally presents two types of menu
items: 1) patient-specific items and 2) items that are not
patient-specific. Patient-specific items reveal more detailed
information about a selected patient, therefore the user must
select a specific patient in the inpatient activity window 36 prior
to activating the context menu 66 and selecting a patient-specific
menu item. The user selects a specific patient within the
inpatients activity window 36 by positioning the on-screen pointer
over a small box 68 just to the left of the name 60 of the patient
to be selected and pressing the designated mouse button. If the
patient has been properly selected a pointer 70 will appear within
the gray box 68 and the entire row corresponding to the patient
will change color to highlight the row. The user may then activate
the context menu 66 and select a patient-specific menu item
relating to the selected patient.
[0103] The inpatient activity window context menu 66 presents three
menu items, including patient overview 72, current clinical data
74, and filter patients by 76. The patient overview 72 and current
clinical data 74 menu items are patient specific, while the filter
patients by 76 menu item is not patient specific. Selecting the
patient overview menu item 72 causes the program to present more
information about the selected patient. In one embodiment, the
program launches a patient view user interface for the
corresponding patient when the user selects the patient overview
menu item 72. The patient view is explained below, and therefore
will not be described here.
[0104] Selecting the current clinical data menu item 74 causes the
program to present more clinical information about the selected
patient. In one embodiment, the program launches a visit view user
interface (see FIG. 7-1) for the corresponding patient when the
user selects the current clinical data menu item 74. The visit that
is displayed in the visit view user interface is the current
patient visit, wherein clinical data is displayed beginning with
the date and time the visit view is opened. The amount of clinical
data displayed will depend on the user-defined value of a lab
"lookback" period. Clinical data is displayed even if it spans
multiple visits as long as it is within the lookback period. The
default lab lookback period is seven days, but may be user-defined
via an options menu 78 of the menu toolbar 56. The visit view is
discussed in greater detail below.
[0105] Selecting the filter inpatients by menu item 76 enables the
user to determine how the patients listed in the inpatient activity
window 36 are filtered, or presented. The user may designate, for
example, filter parameters such as one or more services, teams, or
attending physicians to use in selecting patients to include in the
inpatients activity window 36. A current filter parameter 80 is
indicated at a top of the inpatients activity window 36, wherein
the parameter includes two physicians--Lofland and O'Brien--so that
the patients listed in the inpatients activity window are all of
the patients with Lofland and O'Brien as attending physicians.
The Procedures Activity Window
[0106] The procedures activity window 38 presents information
relating to patients who have had, or are scheduled to have, one or
more medical procedures performed on the date designated by the
first date selector 52. In the illustrated embodiment, the medical
procedures are surgical procedures performed by one or more
designated departments, including procedures performed by the
cardiovascular surgery department and catheterization procedures
performed by the cardiology department. As illustrated in FIG. 3,
the department or departments are indicated at a top of the
procedures activity window.
[0107] The procedures activity window 38 presents one row of
information pertaining to each patient. The information includes a
sequence 82, which is the sequence in which multiple procedures
will be done by one physician; a time 84, which is the date and
time of the corresponding procedure; the full name 86 of the
patient; attending physician 88, which is an identifier of the
physician who will be performing the procedure; and a room 90,
which is the location where the procedure is to be performed.
[0108] A procedures context menu 92 is associated with the
procedures activity window 38, and is similar in form and function
to the inpatients context menu 66 described above. Patient overview
94 and current clinical data 96 menu items function substantially
identically to the patient overview 72 and current clinical data 74
menu items, respectively, described above in relation to the
inpatients context menu 66 and therefore will not be discussed in
detail here.
[0109] A view procedure 98 menu item is a patient specific menu
item that presents procedure information relating to a selected
patient. An exemplary procedure form 100 is illustrated in FIG. 5,
wherein the procedure form 100 presents surgical procedure
information. The information presented as part of the illustrated
form 100 includes the patient's medical record number 102, account
number 104, admission date 106, surgery information 108, surgical
consultation information 110, pre-operation testing information
112, as well as various other pieces of information understood by
those skilled in the art. When invoked via the view procedure menu
item 98, the program presents the patient procedure form 100 in a
protected mode so that the form data cannot be altered by the user.
The form information relates to the scheduled procedure of the
patient selected in the procedures activity window 38.
[0110] The edit procedure 114 menu item is similar to the view
procedure 98 menu item, except that selecting the edit procedure
114 menu item enables the user to add, change, or remove
information relating to a particular procedure. When selected, the
edit procedure 114 menu item opens the procedure form 100 in an
unprotected mode so that one or more of the data fields may be
altered by the user. To avoid unauthorized users from altering the
procedure information, the program only allows designated users to
select this menu item, such as users with the role of system
administrator, administrator, or doctor.
[0111] The view/enter surgical data 116 menu item is also a patient
specific menu item that can be selected only be designated users,
such as those with the role of system administrator, administrator,
or doctor. When selected, the view/enter surgical data 116 menu
item opens the visit view to the operative tab (410) as illustrated
in FIG. 20. The patient's visit associated with the selected
procedure in the procedures activity window 38 will be opened and
the operative tab will display all surgical procedures that
occurred during that visit. As illustrated in FIG. 20, the
operative tab presents procedure information in substantially the
same format as the procedure form 100. The visit view is described
in greater detail below.
[0112] Selecting the update appointments from HIS 118 menu item
causes the program to update the scheduled appointments and
surgical procedures of the program with any cardiovascular surgery
or cardiology appointments that have recently been added, changed,
or deleted by or through the hospital information system (HIS). The
update appointments from HIS 118 menu item is a non-specific
context menu item that can be selected only by designated users,
such as those with the role of system administrator and
administrator. If a new cardiovascular surgery appointment is
received, the program will also automatically create a minimal
dataset of surgical information and associate the dataset with that
particular surgical appointment. A user can thus add more detailed
information relating to the new appointment as the information
becomes available. The program is operable to automatically go
through this process of updating appointments at predefined or
user-defined intervals, such as every ten minutes, to ensure that
all appointment data is updated on a timely basis.
[0113] The filter procedures by 120 menu item is similar to the
filter inpatients by 76 menu item of the inpatient context menu 66,
described above. Selecting the filter procedures by 120 menu item
of the procedures context menu 92 enables the user to determine how
the patients listed in the procedures activity window 38 are
filtered, or presented. The user may designate, for example, filter
parameters such as one or more services, teams, or attending
physicians to use in selecting patients to include in the
procedures activity window 38. The filter function is discussed in
greater detail below. A current filter parameter 122 is indicated
at a top of the procedures activity window 38.
The Clinics Activity Window
[0114] The clinics activity window 40 presents information relating
to clinical appointments on a date determined by the first date
selector 52. The illustrated activity window 40 presents a list of
patients who have had, or are scheduled to have, one or more
non-surgical or non-catheterization appointments on the date
indicated by the first date selector 52. The clinics activity
window 40 includes appointments at, for example, cardiology
clinics, as well as surgery pre-operation, and surgery follow-up
appointments at one or more hospital locations. As illustrated in
FIG. 4, the specific groups or individuals displayed in the clinics
activity window 40 is indicated at a top of the window 40.
[0115] The clinics activity window 40 presents one row of
information pertaining to each patient. The information includes a
time 124 of the clinic appointment; full name 126 of the patient;
type of appointment 128; attending physician identifier 130,
identifying the physician with whom the appointment is scheduled;
and room 132 where the clinic appointment will be held.
[0116] A clinics context menu 134 associated with the clinics
activity window 40 is also illustrated in FIG. 4. The clinics
context menu 134 is similar in form and function to the inpatients
context menu 66 described above. The patient overview 136 and
filter appointments by 138 menu items function substantially
identically to the patient overview 72 and filter inpatients by 76
menu items described above in relation to the inpatients context
menu 66, and therefore will not be described in detail here.
The Daily Schedule Activity Window
[0117] The daily schedule activity window 42 displays the user's
daily schedule for the date corresponding to the first date
selector 52. The user may view today's schedule, for example, or
the schedule of another day by changing the first date selector
52.
The Rounds Activity Window
[0118] The rounds activity window 44 presents patient information
oriented toward one or more teams, such as a heart team, perfusion
team, and so forth. A team typically includes two or more doctors,
but may include a single doctor in some circumstances. Teams
transcend the boundaries of services or attending physicians, and
often include patients until they are discharged from the hospital,
regardless of changes in attending physician, services, or both. As
illustrated in FIG. 3, a title bar 140 of the rounds activity
window 44 displays which team the listed patients are associated
with.
[0119] The rounds activity window 44 presents information that is
similar to that of the inpatients activity window 36, including
each patient's full name 142, an identifier 144 of a physician
currently attending the patient, and a current location 146 of the
patient. The rounds activity window 44 also functions similarly to
the inpatients activity window 36. The program automatically adds
patients to the rounds activity window 44, for example, when the
patients are assigned to a team. A difference between the rounds
activity window 44 and the inpatients activity window 36 is that
team members add patients to the rounds activity window 44, and the
patients are only removed if a team member removes them or the
patient is discharged from the hospital. Furthermore, if an
inpatient is transferred to another hospital service or attending
physician, his or her information will be removed from the
inpatients activity window 36 but will remain in the rounds
activity window 44 until a team member removes the information or
the patient is discharged from the hospital.
[0120] A rounds context menu 148 associated with the rounds
activity window 44 is illustrated in FIG. 4. The rounds context
menu 148 is similar in form and function to the inpatients context
menu 66 described above. Patient overview 150 and current clinical
data 152 menu items of the rounds context menu 148 function
substantially identically to corresponding inpatient context menu
items described above in relation to the inpatients context menu
66, and therefore will not be described in detail here.
[0121] An add inpatient to rounds menu item 154 enables the user to
add a patient to the rounds of a particular team. To add a patient
to the rounds activity window 44, the user must be a member of the
team to which the patient will be added, and must also be a system
administrator, administrator, doctor, or advanced practice nurse
(APN). When an authorized user selects the add inpatient to rounds
menu item 154, the program presents a form for assisting the user
in adding an inpatient to the rounds activity window 44. An
exemplary form 156 is illustrated in FIG. 6, wherein the form 156
lists all of the current inpatients, as indicated by the HIS, and
includes an add patient button 158 and a cancel button 160. The
user adds an inpatient to the rounds activity window 44 by
selecting a patient from the list of patients presented in the form
156 and then selecting the add patient button 158. The user may
cancel the transaction without adding a new patient to the rounds
activity window 44 by selecting the cancel button 160.
[0122] The remove inpatient from rounds menu item 162 enables the
user to remove a patient from the rounds of a particular team. To
remove a patient from the rounds activity window 44, the user must
be a member of the team from which the patient will be removed, and
must also be a system administrator, administrator, doctor, or
advanced practice nurse (APN). The remove inpatient from rounds
menu item 162 is a patient-specific menu item, therefore the user
must select a specific patient from the rounds activity window 44
prior to activating the rounds context menu 148 and selecting this
context menu item.
[0123] The add/edit round notes menu item 164 enables the user to
add or edit notes pertaining to a particular patient. To select
this menu item the user must be a system administrator or an APN.
The add/edit round notes menu item 164 is a patient-specific menu
item, therefore the user must select a specific patient from the
rounds activity window 44 prior to activating the rounds context
menu 148 and selecting this context menu item. When this menu item
is selected, the program presents a rounds notes form 166 as
illustrated in FIG. 7. The rounds notes form 166 enables the user
to submit notes pertaining to the selected patient, which notes
will be available in a rounds report 168, illustrated in FIG. 9 and
described in more detail below.
[0124] The rounds notes form 166 includes various data entry
elements for receiving information from the user. The illustrated
form 166 includes text boxes for receiving a medical record number
170, account number 172, room and doctor 174, patient name and
procedure 176, patient age and weight 178, medications 180,
comments 182, X-ray and lab information 184, and plan information
186. Each text entry box represents one column of the rounds report
168, and the data entered in each column will appear in the proper
column of the rounds report 168 pertaining to the selected
patient.
[0125] The rounds notes form 166 also includes a save button 188, a
cancel button 190, and an add event button 192. Selecting the save
button 188 stores the data entered in the text boxes and closes the
form 166. Selecting the cancel button 190 closes the form 166
without saving any data. Selecting the add event button 192 opens
an event form (described below) so that the user can enter a
special event associated with this patient.
[0126] The add/edit round miscellaneous menu item 194 of the rounds
context menu 148 is a non-patient specific menu item that enables
the user to submit information that will appear in a top section
196 or a bottom section 198 of the rounds report 168. Only users
with designated roles can select this menu item, such as users with
the role of system administrator and APN. Selecting the add/edit
rounds miscellaneous menu item 194 causes the program to present
the add/edit rounds miscellaneous form 200 illustrated in FIG. 8.
The user selects an on-service cardiologist from a cardiologist
drop down menu 202, and the name and phone number of the on-service
cardiologist is placed in the top section 196 of the rounds report
168. The user selects an on-service intensivist from an intensivist
drop down menu 204, and the name and phone number of the on-service
intensivist is also placed in the top section 196 of the rounds
report 168.
[0127] The user may submit information in a miscellaneous notes
section 206 and a to do notes section 208, which information is
placed in the bottom section 198 of the rounds report 168. If the
user selects a save button 210, the program stores the data in the
form 200 and closes the form 200. If the user selects a cancel
button 212, the program closes the form 200 without storing any
data.
[0128] The create rounds report menu item 214 of the rounds context
menu 148 is a non-patient specific menu item that enables the user
to quickly view information about each patient listed in the rounds
activity window 44. When the user selects the create rounds report
menu item 214, the program gathers information about each patient
listed in the rounds activity window 44 and presents the
information in the rounds report 168 illustrated in FIG. 9. The
rounds report 168 can then be printed and used by, for example,
doctors or nurses who are performing rounds on the patients. The
rounds report 168 is a conventional report including information
readily understood by those skilled in the art, and therefore will
be described herein in greater detail.
[0129] The filter rounds by menu item 216 is similar to the filter
inpatients by menu item 76 of the inpatient context menu 66,
described above. Selecting the filter rounds by menu item 216 of
the rounds context menu 148 enables the user to determine how the
patients listed in the rounds activity window 44 are filtered, or
presented. The user may designate, for example, filter parameters
such as one or more services, teams, or attending physicians to use
in selecting patients to include in the rounds activity window
44.
The Consults Activity Window
[0130] The consults activity window 46 presents information about
patients who are associated with a physician or a team of
physicians in a consultation relationship. As illustrated in FIG.
4, a title bar 218 of the consults activity window 46 displays
which team or physician the listed patients are associated
with.
[0131] The consults activity window 46 presents information that is
similar to that of the inpatients activity window 36, including
each patient's full name 220, a physician identifier 222 of a
physician currently attending the patient, and a current location
224 of the patient. The consults activity window 46 also functions
similarly to the inpatients activity window 36. A difference
between the consults activity window 46 and the inpatients activity
window 36 is that team members and physicians add patients to the
consults activity window 46, and the patients are only removed if a
team member or physician removes them or the patient is discharged
from the hospital. Furthermore, if an inpatient is transferred to
another hospital service or attending physician, the program
removes his or her information from the inpatients activity window
36 but does not remove the information from the consults activity
window 46 until a team member specifically requests removal of the
information or the patient is discharged from the hospital.
[0132] A consults context menu 226 associated with the consults
activity window 46 is also illustrated in FIG. 4. The consults
context menu 226 is similar in form and function to the inpatients
context menu 66 described above. Patient overview 228 and current
clinical data 230 menu items of the rounds context menu 226
function substantially identically to corresponding inpatient
context menu items described above in relation to the inpatients
context menu 66.
[0133] An add inpatient to consults menu item 232 enables the user
to add a patient to the consults of a particular team. To add a
patient to the consults activity window 46, the user must be a
member of the team to which the patient will be added or a
physician, and must also be a system administrator, administrator,
doctor, advanced practice nurse (APN), or perfusionist. When an
authorized user selects the add inpatient to consults menu item
232, the program presents a form for assisting the user in adding
an inpatient to the consults activity window 46. An exemplary form
156 is illustrated in FIG. 6 and described above.
[0134] A remove inpatient from consults menu item 234 enables the
user to remove a patient from the consults activity window 46. To
remove a patient from the consults activity window 46, the user
must be a member of a team if the patient will be removed from that
team, and must also be a system administrator, administrator,
doctor, APN, or perfusionist. If a patient is included in the
consults of an individual physician, only that physician can remove
the patient from his or her consults list. The remove inpatient
from rounds menu item 234 is a patient-specific menu item,
therefore the user must select a specific patient from the consults
activity window 46 prior to activating the consults context menu
226 and selecting this context menu item.
[0135] The filter consults by 236 menu item is similar to the
filter inpatients by menu item 76 of the inpatient context menu 66,
described above. Selecting the filter consults by menu item 236 of
the consults context menu 226 enables the user to determine how the
patients listed in the consults activity window 46 are filtered, or
presented. The user may designate, for example, filter parameters
such as one or more services, teams, or attending physicians to use
in selecting patients to include in the consults activity window
46.
The Cath Conference and Personal Notes Activity Windows
[0136] The cath conference activity window 48 contains a list of
all patients that are scheduled to be presented to or have been
presented to the catheterization conference on date indicated by
the second date selector 54. The personal notes activity window 50
contains notes that can be written and responded to by user,
attending physician, team, or department.
The Filter Function
[0137] When the user selects a "filter by" context menu item from
any of the context menus described above, the program presents a
filter by form 238 illustrated in FIG. 10. A "filter by" set of
radio buttons includes a service button 240, team button 242, and
attending physician button 244. If the user selects the service
radio button 240, for example, the program presents patients that
are scheduled to receive, or have received, a particular service.
An available sources window 246 presents the available filter
parameters for each filter option. As illustrated, for example, if
the attending physician radio button 244 is selected, the available
sources window 246 presents all possible attending physicians for
the user to choose from. A single add button 248 enables the user
to add the selected physician to a selected sources window 250, and
an add all button 252 enables the user to add all sources to the
selected sources window 250. A single remove button 254 and a
remove all button 256 similarly function to move sources from the
selected sources window 250 to the available sources window
246.
[0138] A save as default setting checkbox 258 enables the user to
save the current settings as default settings, and a restore
default button 260 enables the user to abandon any current settings
and revert to the previously-saved default settings. Selecting an
ok button 262 stores and applies the current settings and closes
the window, and selecting a cancel button 264 closes the window
without storing or applying any settings.
The Patient View
[0139] Referring to FIG. 11, the patient view presents a top-level
interface 300 that enables physicians, nurses, clinical care givers
or other users to view detailed information associated with a
particular patient. The illustrated patient view interface 300
includes various information tabs, wherein each tab relates to a
separate interface element. In the illustrated interface 300,
selecting a tab presents an interface element with various
information windows. The tabs include medical history 302, heart
lab 304, radiology 306, demographics 308, studies 310, epidemiology
312, and genetics 314. The interface 300 also presents a plurality
of patient identifier fields 316 that provide identification
information about the current patient.
[0140] The menu toolbar 56 is located near a top of the interface
300 and enables the user to select items and options that apply
universally and are not associated with a specific tab or
information window. The interface 300 also provides context menus
that enable the user to select items and options that are
associated with a specific information window, and enable the user
to drill down to view more detailed information about a selected
piece of information that is presented in an information window. As
explained above in relation to the department view interface 34, a
context menu associated with each information window is activated
when the user positions an on-screen pointer or arrow over the
specific activity window and selects a designated input button,
such as the right mouse button.
[0141] The patient identifier fields 316 remain at the illustrated
location to the left of the patient tabs regardless of which
patient identifier tab the user is viewing. The patient identifier
fields 316 include the patient's medical record number (MRN); the
patient's last name; the patient's first name; the patient's date
of birth; the patient's gender; the ethnic origin of the patient;
and the age of the patient in years, months and days. The MRN is a
unique patient identifier number assigned by the hospital to each
patient on record. All of a patient's medical records are
referenced by this unique number each time the patient visits the
hospital.
The Medical History Tab
[0142] The medical history tab 302 presents information relating to
various aspects of the patient's medical history. The illustrated
medical history tab 302 presents seven information windows,
including previous visits 318, procedures 320, scheduled visits
322, diagnoses 324, medications 326, complications 328, and
allergies 330 information windows.
[0143] The previous visits information window 318 presents a list
and brief description of all prior activity that the selected
patient has had with the hospital. The illustrated previous visits
information window 318 includes one row of information for each
visit or activity, wherein the rows are divided into columns
corresponding to a date of the visit 332; status 334, or type of
visit; and reason 336 for the visit. An exemplary list of types of
visits that may be included in the status column 334 includes
inpatient (INP), outpatient (OUT), emergency room (ER), and
diagnostic transfer activities (DXTXR).
[0144] A previous visits context menu 338 is illustrated in FIG.
12, which includes only a single menu item 340 labeled "view visit
details." The view visit details context menu item 340 is specific
to an activity or visit, therefore the user must select a visit or
activity prior to activating the context menu 338 and selecting
this menu item. The visit or activity is selected by using a
pointing device to select a small box to left of the visit or
activity, as explained above in relation to the department view
user interface 34. When the user selects the view visit details
menu item 340 the program automatically opens the visit view for
the selected patient. Any clinical information associated with this
visit will be displayed in the visit view. The visit view is
described in greater detail below.
[0145] The procedures information window 320 presents a list and
brief description of all prior procedures that the patient has had
at the hospital. There is one row of data in this window for each
separate procedure that the patient has had, even if there are
multiple procedures during one patient visit. The rows are divided
into columns corresponding to date of the procedure 342; attending
surgeon 344; and procedure 346, which indicates the primary
procedure associated with this surgery. A procedures information
window context menu 348 is illustrated in FIG. 12, wherein the menu
348 presents a single item 350 labeled "view surgical data." When
the user selects the view surgical data 350 menu item the program
launches the operative tab of the visit view associated with the
selected procedure. As explained below, the operative tab presents
information associated with the procedure.
[0146] The scheduled visits information window 322 presents a list
of future visits that are scheduled for the patient. There is one
row of data in this window for each scheduled visit, wherein the
rows are divided into columns representing appointment 352, which
is the date and time of the scheduled visit; type of visit 354;
attending physician 356, which includes an attending physician
identifier who the visit is scheduled with; and room 358 where the
visit is scheduled. A scheduled visits information window context
menu 360 includes a single item 362 labeled "add a new appointment
and surgery." When the user selects the add a new appointment and
surgery menu item 362, the program presents a new appointment form
364 illustrated in FIG. 13.
[0147] The new appointment form 364 presents various data fields
through which the user submits information relating to a new
appointment or new surgery. An MRN data field 366 contains the
medical record number of the patient associated with the
appointment. An account number data field 368 receives an account
number associated with the visit, and a date of the appointment or
surgery data field 370 receives the scheduled dat. The date
presented in the date field 370 is the present date by default, and
the user may select another date using a drop-down menu activator
372. A time data field 374 receives the time of the appointment,
and a surgeon data field 376 enables the user to choose a surgeon
performing the procedure.
[0148] When the user selects a save button 378, the program
schedules the appointment or surgery by saving the information to
the database 20e and creates an empty surgery record to be
completed at a later time. A confirmation message is then presented
to the user, and the appointment immediately appears in the
scheduled visits information window 322. The scheduled appointment
is also accessible via other views and/or interfaces. For example,
when the surgeon logs into the program and launches the department
view (described above), the scheduled appointment will appear in
the procedures activity window 38 when the surgeon selects the date
of the scheduled appointment from the first date selector 52.
[0149] The diagnoses information window 324 presents a list of all
previous diagnoses for the patient. The medications information
window 326 presents a list of all medications that the patient is
currently taking. The complications information window 328 presents
a list of all previous or current complications associated with the
patient. The allergies information window 330 presents a list of
all known allergies associated with the patient. Thus, using the
various information windows of the medical history tab 302, the
user can quickly and easily view patient medical information that
is pertinent to diagnosing illnesses, prescribing medications, and
so forth.
The Heart Lab Tab
[0150] The heart lab tab 304 is illustrated in FIG. 14 and enables
the user to view medical images associated with the patient. When
the heart lab tab 304 is selected, the program automatically
requests updated images from another hospital department. In one
embodiment, the program automatically communicates with the
hospital cardiology imaging system 20c to acquire any
catheterization or echo image studies that have been performed on
the patient. The cardiology imaging system 20c provides a list of
all stored imaging studies for the patient, as illustrated in the
interface window of FIG. 14.
[0151] The interface between the computer 10 implementing the
present invention and the cardiology imaging system 20c may include
a web client window and an active-x control located in an imaging
tab frame. When the heart lab tab 304 is selected, the program
sends a username, password, and medical record number to the
web-based cardiology imaging system 20c. The cardiology imaging
system responds by opening a web session to the program and
displaying all of the studies for the selected medical record
number. The imaging system web session is then displayed in a web
client of the heart lab tab 304. The user then has all the
functionality of the cardiology imaging system in the web client
window of the heart lab tab 304.
[0152] An exemplary echocardiogram 380 communicated to and
presented by the heart lab tab 304 is illustrated in FIG. 15. A
control box 382 created by the echocardiogram software presents a
series of controls that enable the user to choose between several
images and manipulate the image 380 currently displayed. These
controls will be readily recognized by those skilled in the art and
therefore will not be described in detail here.
The Radiology Tab
[0153] The radiology tab 306 is illustrated in FIG. 16. The
radiology tab 306 is similar to the heart lab tab 304 in that it
enables the user to view medical images associated with the
patient. When the user selects the radiology tab 306, the program
automatically requests updated images from the hospital radiology
imaging system 20b to acquire any film, echo, CT, or other image
studies that have been performed on the patient. The cardiology
imaging system 20b will respond back with a list of all stored
radiology studies for that patient, as shown in FIG. 16.
[0154] The interface between the program and the radiology imaging
system 20b is a web client window and an active-x control located
in a radiology tab frame. When the radiology tab 306 is selected,
the program sends a username, password, and medical record number
to the web-based radiology imaging system. The radiology imaging
system 20b responds by opening a web session to the program and
displaying all studies for the selected medical record number. The
radiology imaging system web session is then displayed in the web
client of the radiology tab 306. The user then has all the
functionality of the radiology web-based imaging system in the web
client window of the radiology tab 306. An exemplary radiology web
session is illustrated in FIG. 17, wherein two images are presented
concurrently.
The Demographics Tab
[0155] The demographics tab 308 is illustrated in FIG. 18 and
presents general, family, and provider information associated with
the patient. The demographic information is presented in various
user interface sections relating to patient information 384, next
of kin information 386, emergency contact information 388, family
provider information 390, and primary care physician information
392. The program automatically retrieves the information in each of
these sections from the HIS 20a when a patient is submitted to the
program. The program also automatically updates the demographic
information with any changes made to the HIS 20a at pre-determined
times, such as on the day before a scheduled appointment and on the
day after a scheduled appointment.
The Studies Tab
[0156] The studies tab 310, illustrated in FIG. 19, presents
information about studies the patient is currently enrolled in. The
tab 310 allows the user to view, submit, and modify information
about a study when the user selects that study from a list 394 of
studies.
The Epidemiology and Genetics Tabs
[0157] The epidemiology tab 312 and the genetics tab 314 present
epidemiological information and genetic information, respectively,
pertaining to the selected patient. This information may be
presented in much the same form as the medical history and
demographics information discussed above.
The Visit View
[0158] Referring to FIG. 20, the visit view presents a top-level
interface 400 that enables physicians, nurses, clinical caregivers
and other users to view detailed information associated with a
hospital visit of a particular patient. The illustrated visit view
interface 400 includes various information tabs, wherein each tab
relates to a particular type of information. In the illustrated
interface 400, selecting a tab presents an interface element with
various information windows. The illustrated tabs include diagnoses
402, heart lab 404, radiology 406, pre-operative 408, operative
410, post-operative 412, reports 414, discharge 416, and follow up
418. The top-level interface 400 also presents a plurality of
patient identifier fields 420 that provide identification
information about the current patient. The patient identifier
fields 420 are substantially identical to the patient identifier
fields 316 that are presented as part of the patient view,
described above.
[0159] The Diagnoses Tab
[0160] The diagnoses tab 402 presents information about one or more
diagnoses of a patient during a visit.
[0161] The Heart Lab and Radiology Tabs
[0162] The heart lab tab 404 and the radiology tab 406 are
substantially identical to the heart lab tab 304 and the radiology
tab 306 presented as part of the patient view, described above.
Therefore, these tabs will not be described in detail here.
[0163] The Pre-Operative Tab
[0164] The pre-operative tab 408 includes pre-operative medical
information for the selected patient. The pre-operative tab 408
includes a pre-op review section and a details section. The pre-op
review section includes the complete pre-operative data sheet for
the selected patient, while the details section includes more
detailed pre-operative data.
[0165] The Operative Tab
[0166] The operative tab 410 is illustrated in FIG. 20 and presents
information relating to surgeries performed during the selected
patient's visit. The surgical information is divided into several
tabs nested within the operative tab 410, wherein the nested tabs
are located along a top of the operative tab and include a general
information tab 422, a surgical details tab 424, a valves and
homografts tab 426, a perfusion tab 428, and an anesthesiology tab
430.
[0167] The general information tab 422 presents a list of surgeries
in a top portion 432 of the tab 422, wherein the list includes
various pieces of information associated with each surgery. The
illustrated list of surgeries includes a date 434 of the surgery,
attending physician 436, surgery type 438, current procedure
terminology (CPT) 440, and a description 442 of the primary
procedure for each surgery. When a particular surgery is
highlighted, such as when the user selects the surgery with an
input device, various data fields in a lower section 444 of the tab
422 are updated to reflect the selected surgery.
[0168] The data fields of the lower section 444 of the general
information tab 422 include MRN 446, account number 448, and date
450 the patient was admitted for the surgery. A surgery data
section 452, surgical consultation data section 454, and pre-op
testing data section 456 each include date, time and location
fields. An attending physician data field 458 indicates the
patient's attending physician, and a surgery type data field 460
indicates the type of surgery that was performed on the patient. A
cardiologist data field 462 indicates the patient's cardiologist,
and a procedure sequence data field 464 indicates a sequence
associated with the procedure, such as initial, staged, repeat,
chest closure, and so forth. Patient age 466, weight 468, and
height 470 data fields present the indicated patient information. A
prior total CV surgeries data field 472 indicates the total number
of cardiovascular surgeries this patient has had, while a prior
open CV surgeries data field 474 indicates the number of open
cardiovascular surgeries this patient has had.
[0169] A patient origin data field 476 indicates where the patient
went to surgery from, such as pediatric intensive care unit, same
day surgery (SDS), hospital bed, and so forth. A scheduling status
data field 478 indicates how the surgery was scheduled, such as
elective, urgent, emergent, and so forth. A body surface area data
field 478 provides a calculation of the patient's body surface area
based on the patient's height and weight. An initial indications
data field 480 lists pre-operative patient diagnoses. An antenatal
diagnosis checkbox 482 indicates whether the procedure related to
fetal diagnosis, and a TEE required checkbox 484 indicates whether
a transesophogeal echo was required.
[0170] The surgical details tab 424 presents information relating
to the diagnoses, procedures, and complications associated with the
surgery that is selected from the general information tab 422. As
illustrated in FIG. 21, the surgical details tab 424 is divided
into three sections. A first section 486 is dedicated to diagnoses,
a second section 488 is dedicated to procedures, and a third
section 490 is dedicated to complications. Each section contains a
context menu item which allows the user to enter primary and
secondary surgical diagnoses, procedures, and complications.
[0171] The valves and homografts tab 426 presents information
related to any valves, homografts, or both used during the surgery
that is selected from the general information tab 422. The
perfusion data tab 428 presents perfusion data collected during the
surgery that is selected from the general information tab 422. The
anesthesiology tab 430 presents anesthesiology information
collected during the surgery that is selected from the general
information tab 422.
[0172] The Post-Operative Tab
[0173] The post-operative tab 412 is illustrated in FIG. 22 and
presents information relating to the patient's status after the
surgery. The post-operative tab 412 includes a series of nested
tabs arranged horizontally near a top of the tab 412. The nested
tabs include blood gases 492, hematology 494, coagulation 496,
chemistry 498, endocrinology 450, liver profile 452, urinalysis
454, other tests 456, ins and outs 458, events 460, and vital signs
462.
[0174] The blood gases tab 491 presents laboratory information
pertaining to the patient's blood gases. The blood gases tab 492 is
divided into two areas: a top area presents a blood gases lab
result table 514, and a bottom area presents a blood gases chart
516.
[0175] The blood gases result table 514 lists all of the blood gas
laboratory results for the selected patient over a predetermined
period of time. The length, beginning date, and ending date of the
predetermined period of time depends on how the visit view was
invoked. If the user invoked the visit view by selecting a current
clinical data context menu item from the department view, for
example, the predetermined period of time is the user-defined
"lookback" period that ends with today's date and begins a
user-determined number of days prior to today's date.
Alternatively, if the user invoked the visit view by selecting a
previous visit from the patient view and then selected the view
clinical data menu item 340, the predetermined period of time
corresponds to that visit so that the information includes all of
the lab results collected during the visit.
[0176] The blood gases lab result table 514 lists all lab results
in reverse chronological order, so that the most recent lab result
is always at the top of the list. Each blood gas result occupies a
separate row of the table, and each row is divided into columns. A
first column 518 of each row, denoted "collected," specifies the
date and time that the sample was collected from the patient.
Subsequent columns present specific lab results, such as BGS 520,
PH 522, PCO2 524, and so forth. The lab results can include numeric
or textual information. To the right of some of the lab result
columns is an unmarked status column 526 for displaying an
indication from the laboratory of the status of the result in the
corresponding results column. If a particular lab result is within
a normal range, the corresponding status column is left unmarked.
Alternatively, the status column may be marked CL, L, H, or CH to
indicate that the lab result is critically low, low, high, or
critically high, respectively.
[0177] An exemplary use of the status column is illustrated in
connection with a calcium ion lab results column 528. In the
illustration, the result of a first blood test performed on January
14 was 1.37, the result of a second blood test performed on January
14 was 1.38, and the result of a third blood test performed on
January 14 was 1.38. Because the 1.37 result is within the normal
range, the status column box corresponding to the first test
remains unmarked. Furthermore, the 1.38 results are high, therefore
the status column boxes corresponding to the second and third
results are each marked "H," indicating that the result is high. A
user can thus quickly and easily determine which results are normal
and which results present potential challenges. An exemplary list
of blood gases that are tested is illustrated in the table of FIG.
23.
[0178] The blood gas chart 516 is presented in the blood gases tab
492 concurrently with the blood gases lab result table 514. The
chart 516 presents graphical information associated with the lab
results from multiple tests plotted over time. The illustrated
chart 516 plots the values of four blood gas tests across multiple
test dates beginning on Jan. 1, 2005 and ending on Jan. 17, 2005.
As illustrated in a key 530 to the right of a graph 532 of the
chart 516, the chart 516 plots the values of base excess (BE),
venous base excess (VBE), PH, and venous PH. Each of the plots is
placed on the same graph 532, therefore each is presented in a
different color. The key 530 indicates which color each graph is
plotted in by illustrating the line next to each label in the
corresponding color.
[0179] The chart 516 is built by first going through every value in
each laboratory test result set and converting it to a numeric
value. If a particular data point value cannot be converted to a
numeric value, it is removed from the dataset of that lab result
series. During this process, the earliest and latest collection
times of all four series are also determined. These two times form
the range of the horizontal axis (time) scale of the graph 532. The
range of the left vertical axis is determined by the minimum and
maximum values of all BE and VBE data, and the range of the right
vertical axis is determined by the minimum and maximum values of
all PH and VPH data. The left and right vertical axes are
automatically ranged for each respective minimum and maximum value,
so there is not necessarily a "zero" value along the vertical axis
for either range.
[0180] The values for each measurement are then placed in their
proper location within the horizontal (time) and vertical (value)
boundaries of the graph 532. All consecutive data points are then
connected for a particular lab value, beginning at the earliest
value along the horizontal (time) axis for that lab result and
ending with the latest time value for that test result. The lines
connecting two consecutive lab results are for reference only, and
do not necessarily represent any measurements between those two
discreet data points. It is also important to note that the
connecting line segments begin with the first lab result for that
test type and end with the last lab result for that test type.
Therefore lines will not begin before the first actual data point
or extend beyond the last data point for a particular lab
series.
[0181] The hematology tab 494 is illustrated in FIG. 24 and
presents a patient's hematological laboratory information. The
hematology tab 494 is divided into two areas: an upper area
presents a hematology lab result table 534, and a lower area
presents a hematology chart 536. The hematology lab result table
534 is substantially identical in form and function to the blood
gases result table 514 described above, except that the hematology
lab result table includes laboratory test results pertaining to
hematology, such as white blood count, red blood count, hemoglobin,
and so forth. A table of hematology data is illustrated in FIG.
25.
[0182] The hematology chart 536 is similar in form and function to
the blood gases chart 516 described above. The hematology chart 536
plots color-coded values for hemoglobin (Hgb), white blood count
(WBC), and platelets. The chart is built by first finding the
earliest and latest collection times of the three values. These two
times form the range of the horizontal axis (time) scale. The range
of the left vertical axis is determined by the minimum and maximum
values of the Hgb and WBC data, and the range of the right vertical
axis is determined by the minimum and maximum values of all
platelets data. The left and right vertical axis values are
automatically ranged for each respective minimum and maximum value,
so there is not necessarily a "zero value for either range. The
values for each measurement are then placed in their proper
location within the horizontal and vertical boundaries of the
chart, and consecutive data points are connected for particular lab
value.
[0183] The coagulation tab 496 is illustrated in FIG. 26 and
presents a patient's coagulation information. The coagulation tab
496 is divided into two areas: an upper area presents a coagulation
lab result table 538, and a lower area presents a coagulation chart
540. The coagulation lab result table 538 is substantially
identical in form and function to the blood gases result table 514
described above, except that the coagulation lab result table 538
includes laboratory test results pertaining to coagulation. A table
of coagulation data is illustrated in FIG. 27.
[0184] The coagulation chart 540 is similar in form and function to
the blood gases chart 516 described above. The coagulation chart
540 plots color-coded values for Protime, aPTT, and INR. The chart
is built by first finding the earliest and latest collection times
of the three values. These two times form the range of the
horizontal axis (time) scale. The range of the left vertical axis
is determined by the minimum and maximum values of the Protime and
aPTT data, and the range of the right vertical axis is determined
by the minimum and maximum values of all INR data. The left and
right vertical axis values are automatically ranged for each
respective minimum and maximum value, so there is not necessarily a
"zero" value for either range. The values for each measurement are
then placed in their proper location within the horizontal and
vertical boundaries of the chart, and consecutive data points are
connected for particular lab value, as explained above in relation
to the blood gases tab 492.
[0185] The chemistry tab 498 is illustrated in FIG. 28 and presents
chemistry laboratory test results associated with the selected
patient. The chemistry tab 498 is divided into two areas: an upper
area presents a chemistry lab result table 542, and a lower area
presents a chemistry chart 544. The chemistry lab result table 542
is substantially identical in form and function to the blood gases
result table 514 described above, except that the chemistry lab
result table 542 includes chemistry laboratory test results, such
as sodium, potassium, and so forth. A table of chemistry data is
illustrated in FIG. 29.
[0186] The chemistry chart 544 is similar in form and function to
the blood gases chart 516 described above. The chemistry chart 544
plots color-coded values for BUN, Anion Gap, and Creatinine. The
chart is built by first finding the earliest and latest collection
times of the three values. These two times form the range of the
horizontal axis (time) scale. The range of the left vertical axis
is determined by the minimum and maximum values of the BUN and
Anion Gap data, and the range of the right vertical axis is
determined by the minimum and maximum values of all Creatinine
data. The left and right vertical axis values are automatically
ranged for each respective minimum and maximum value, so there is
not necessarily a "zero" value for either range. The values for
each measurement are then placed in their proper location within
the horizontal and vertical boundaries of the chart, and
consecutive data points are connected for particular lab value, as
explained above in relation to the blood gases tab 492.
[0187] The endocrinology tab 500 is illustrated in FIG. 30 and
presents a patient's endocrinology laboratory test results. The
endocrinology tab 500 includes an endocrinology lab result table
546 that is substantially identical in form and function to the
blood gases result table 514 described above, except that the
endocrinology lab result table 546 includes endocrinology
laboratory test results. The illustrated endocrinology lab result
table includes results for T4, TSH, and free T4.
[0188] The liver profile tab 502 is illustrated in FIG. 31 and
presents a patient's liver profile laboratory test results. The
liver profile tab 502 presents a liver profile lab result table
548. The liver profile lab result table 548 is substantially
identical in form and function to the blood gases result table 514
described above, except that the liver profile lab result table 548
includes liver profile laboratory test results, such as T Prot, T
Bili, and so forth. A table of exemplary liver profile lab result
data is illustrated in FIG. 32.
[0189] The urinalysis tab 504 is illustrated in FIG. 33 and
presents a patient's urinalysis laboratory test results. The
urinalysis tab 504 presents a urinalysis lab result table 550. The
urinalysis lab result table 550 is substantially identical in form
and function to the blood gases result table 514 described above,
except that the urinalysis lab result table 550 includes urinalysis
laboratory test results, such as volume, color, clarity, and so
forth. A table of exemplary urinalysis lab result data is
illustrated in FIG. 34.
[0190] The other tests tab 506 is illustrated in FIG. 35 and
presents a patient's laboratory test results that are not included
in one of the previously-defined laboratory groups. The other tests
tab 506 presents a lab result table 552. The other tests lab result
table 552 is substantially identical in form and function to the
blood gases result table 514 described above, except that the other
tests lab result table 552 includes laboratory test result
information that is not limited to a particular type or category of
test. The illustrated other tests lab result table 552 includes a
collected column for indicating a date the laboratory test
information was collected; a category column for indicating a
category of the test being performed; a result type column for
indicating a specific name of the test being performed; a result
column for indicating a result, or value, of the test being
performed; status column for indicating whether the test result is
normal or abnormal; a units column for indicating the unit of
measure of the test result; and a normal range column for
indicating a normal range of the test result for this patient. The
status column may include indicators such as H, CH, L, and CL
corresponding to high, critically high, low, and critically low,
respectively. If a box of the status column is empty, the
corresponding test result was normal.
[0191] The ins and outs tab 508 is illustrated in FIG. 36 and
presents information about all intakes by the selected patient and
outputs from that patient over a particular period of time. The
information typically relates to a twelve-hour period and the
accumulated amounts are recorded on the patient's flow sheet.
Intakes may include blood products, intravenous medications and
fluids, and feeding intakes. Typical outputs include chest tube
drainage and urine. The ins and outs tab 508 is divided into two
areas: an upper area presents an ins and outs result table 554, and
a lower area presents an ins and outs chart 556. The ins and outs
result table 554 is similar in form and function to the blood gases
result table 514 described above, except that the ins and outs
result table 554 includes the intakes and outputs information
described above and generally does not include a status column.
[0192] The table of FIG. 37 lists various values that may appear in
the lab results table 554. Some of the values listed in FIG. 37 are
not visible in the table 554 because they are in columns that are
beyond the scope of the chart window. It will be appreciated that
the columns that are not visible are substantially identical in
form to those that are visible, and may be accessed by manipulating
a scroll bar located near a bottom of the chart window. Each
cumulative intake and output entry is on a separate row of the
table 554, and the collected column of each row specifies the
ending date and time that the entry represents.
[0193] The ins and outs chart 556 is similar in form and function
to the blood gases chart 516 described above. The ins and outs
chart 556 plots color-coded values for a twelve-hour balance, a
thirty-six hour moving average, and a cumulative value. The
twelve-hour balance represents total intake less total output for
the twelve-hour period as recorded on the nursing flow sheet. The
thirty-six hour moving average represents the average of three
consecutive twelve-hour balances, typically the current twelve-hour
balance and the next two. The thirty-six hour moving average tends
to smooth out the more drastic fluctuations of the twelve-hour
balance, and show a more accurate trend of ins and outs balances.
The cumulative value represents a running total of all twelve-hour
balances over time, both positive and negative, beginning at
zero.
[0194] The ins and outs chart 556 is built by first finding the
earliest and latest collection times of the twelve-hour balance
values. These two times form the range of the horizontal axis
(time) scale. The twelve-hour balance data is then sequenced from
earliest to latest and the thirty-six hour moving average and
cumulative values are calculated. The range of the left vertical
axis is determined by the minimum and maximum values of all
twelve-hour balance and thirty-six hour moving average data, and
the range of the right vertical axis is determined by the minimum
and maximum values of all cumulative data.
[0195] The left and right vertical axis values are automatically
ranged for each respective minimum and maximum value. The values
for each measurement are then placed in their proper location
within the horizontal (time) and vertical (value) boundaries of the
chart. All consecutive data points are then connected for a
particular data series, beginning at the earliest value along the
horizontal axis for that series and ending with the latest
horizontal axis value for that series. The lines connecting two
consecutive data points are for reference only, and do not
necessarily represent any measurements between those two discreet
data points.
[0196] The ins and outs tab 508 also has an associated ins and outs
context menu 560, illustrated in FIG. 44, that is presented in
response to a pre-determined user input, such as depressing a mouse
button. The context menu 560 includes three menu items: add new
record, edit selected record, and delete selected record. When the
user selects the add new record context menu item, the program
presents a blank ins and outs entry form 558, illustrated in FIG.
38.
[0197] The form 558 presents a date field 562 that represents the
ending date of the period for which the ins and outs are being
entered. The value in the date field defaults to the current date,
but the user may change the date in this field by selecting the
drop-down menu button and choosing another date from the drop-down
menu. A time field 564 represents the ending time of the period for
which the ins and outs are being entered. The time field 564 may
also default to a particular time, such as 06:00 or 18:00, which
correspond to nursing flow sheet cut-off times. The default value
may be, for example, the closest previous cut-off time, but can be
any time submitted in the twenty-four hour (00:00) format. The
"Accumulated Until" radio buttons 566,568 are associated with the
time field and allow the user to change the value to the time field
to either 6:00 a.m. (06:00) or 6:00 p.m. (18:00).
[0198] The cumulative intake 570 and cumulative output 572 fields
are read-only fields that maintain running totals of all intake 574
fields and all output 576 fields, respectively. The intake 574
fields and the output 576 fields receive data from the user
relating to each of the topics listed in FIG. 37. A medical record
number (MRN) field 578 defaults to the MRN of the current patient,
but may be changed by the user. An account number field 580
defaults to the account number of the current visit, but may also
be changed by the user. When a new record has been created and
saved, the program automatically and immediately updates the ins
and outs results table 554 and the ins and outs chart 556 to
reflect the new information.
[0199] The edit selected record menu item of the context menu 560
is a record-specific menu item, therefore the user must select a
specific row within the ins and outs result table 554 prior to
activating the context menu 560 and selecting this menu item. Once
this item is selected, the program presents the ins and outs entry
form 558 containing information from the selected row. The user may
then change the values in editable fields and save the new
information by selecting the save button. Once a record has been
edited and saved, the program automatically and immediately updates
the ins and outs results table 554 and the ins and outs chart 556
to reflect the new information.
[0200] The delete selected record menu item of the context menu 560
is a record-specific menu item, therefore the user must select a
specific row within the ins and outs result table 554 prior to
activating the context menu 560 and selecting this menu item. When
the user selects the delete selected record menu item, the program
presents a message asking the user to confirm the deletion of the
selected record. If the user submits a positive response to the
confirmation request, the program automatically deletes the
corresponding ins and outs data and updates the ins and outs
results table 554 and the ins and outs chart 556 to reflect the
change.
[0201] The events tab 510 is illustrated in FIG. 39 and generally
presents event information relating to the selected patient. The
illustrated events tab 510 presents an event timeline table 582 and
a plurality of event category tables. The event category tables
include medications 584, movements 586, pulmonary 588, procedures
590, complications 592, and IV solutions 594.
[0202] The event timeline table 582 lists all of the events that
have occurred for the selected patient over a predetermined period
of time in reverse chronological order. The length, beginning date,
and ending date of the predetermined period of time depends on how
the visit view was invoked. If the user invoked the visit view by
selecting a current clinical data context menu item from the
department view, for example, the predetermined period of time is
the user-defined "lookback" period that ends with today's date and
begins a user-determined number of days prior to today's date.
Alternatively, if the user invoked the visit view by selecting a
previous visit from the patient view and then selected the view
clinical data 340 menu item, the predetermined period of time
corresponds to that visit so that the information includes all of
the lab results collected during the visit.
[0203] Each row of the event timeline table 582 corresponds to an
event, and the rows are divided up into columns of information. A
date/time column indicates a date and time of the event; a category
column indicates a type of the event, wherein the event type
corresponds to one of the event category tables; an event column
presents the main description of the event; and a detail column
presents more detailed information about the event, if
required.
[0204] Events are added to and removed from the event timeline
table 582 via a context menu 596 associated with the table 582. An
add new event context menu item enables the user to enter a new
event of any category into the event timeline table 582 and the
appropriate event category table. When the user selects this
context menu item, the program presents the event entry form 598 as
illustrated in FIG. 40. A date field 600 of the form 598 defaults
to the current date, but the user may change the date by selecting
a drop-down menu button to activate a drop-down menu and choosing a
date from the menu. A time field 602 defaults to the present time,
but the user may change the time to any (valid) time. A medical
record number (MRN) field 604 defaults to the MRN of the current
patient, and an account number field 606 defaults to the account
number of the current visit.
[0205] A category drop-down menu 608 enables the user to select a
category for the event, wherein each available category corresponds
to one of the event category tables. Once the user selects a
category from the category drop-down menu 608, the program presents
an event description 610 drop-down menu. The description drop-down
menu 610 presents various descriptions corresponding to the
selected category. Once the user selects a description of the
event, the program presents a detail drop-down menu 612 if there
are details associated with the description chosen by the user. If
there are not details associated with the description chosen by the
user, the program activates a save button so that the user can save
the new event information. The program also activates the save
button when the user selects detail information from the detail
drop-down menu 612.
[0206] Selecting the delete selected event menu item of the context
menu 596 causes the program to remove the selected event from the
patient's record. The program also automatically removes the row of
the event timeline table 582 and one of the event category tables
corresponding to the event.
[0207] Once an event is entered into the event timeline table 582,
the program automatically associates the event with one of the five
event category tables, depending on which category the user selects
in the add new event form 598 when initially submitting event
information. As explained below in greater detail, specific events
can be plotted in any of the charts described above concurrently
with lab result information.
[0208] The vital signs tab 512 is illustrated in FIG. 41. The tab
512 presents three tables, including a ventilator table 614, a
weight table 616, and a maximum temperature table 618. The
ventilator table 614 displays information associated with
ventilator settings and measurements when a patient is on the
ventilator. Ventilator settings are always recorded along with a
particular blood gas sample, therefore the program generates a new
row in the ventilator table 614 whenever new blood gas lab results
are submitted to the program.
[0209] There is one row of information in the ventilator table 614
for each blood gas lab result received, wherein the information
includes all ventilator settings and measurements that occur for a
specific patient and the rows are presented in reverse
chronological order. The rows are divided into columns including a
date/time column that indicates the date and time of the blood gas
sample and associated ventilator reading; a collected column that
identifies whether the ventilator value has been entered, has been
verified to contain no valid data, or has been verified and
entered; a CBP column; a systolic column for indicating a systolic
blood pressure reading; a diastolic column for indicating a
diastolic blood pressure reading; an FiO2 column; an MAP column for
indicating a mean airway pressure; a hi frequency column for
indicating that the ventilator is set to a high frequency mode; and
a convention column for indicating that the ventilator is set to a
convention frequency mode.
[0210] The user adds, edits, and deletes information from the
ventilator table 614 using a ventilator context menu 620. The
add/edit ventilator settings context menu item enables the user to
add ventilator settings and measurements to a row of the ventilator
table 614 selected by the user. When the user selects a row of the
table 614, that row is entirely highlighted in blue. When the user
activates the context menu 620 and selects the add/edit ventilator
values menu item, the program presents a collect ventilator values
entry form 622, as illustrated in FIG. 42. The program presents the
form 622 with data fields corresponding to date 624, time 626, MRN
628, and account number 630, wherein these data fields are
pre-filled with information for the selected patient, visit, and
ventilator row date and time. Furthermore, those fields are
read-only and cannot be modified by the user.
[0211] If there is no ventilator data associated with a blood gas
lab result, the user checks a no data checkbox 632. This will
indicate that the blood gas lab result has been verified to have no
associated ventilator data, as opposed to a blood gas lab result
which hasn't had the ventilator data entered yet.
[0212] The user enters information into FiO2 634, MAP 636, CVP 638,
and arterial blood pressure systolic 640 and diastolic 642 fields
directly from the flow sheet data for the selected ventilator
entry. The user indicates a vent mode from the vent mode drop-down
menu 644 according to the ventilator mode at the time the entry is
recorded. The program saves the data to the ventilator table 614
row when the user selects the save button, or discards the data
when the user selects the cancel button.
[0213] The weight table 616 lists all weights recording during a
particular patient visit. There is one row of information in the
weight table 616 for each recorded weight, and each row is divided
into columns of information. A date/time column indicates a date
and time that the weight was measured, while a weight column
provides the measured weight in kilograms. The table includes all
weight measurements that occur for a specific patient in reverse
chronological order.
[0214] A weight table context menu 646 presents three context menu
items, including add weight, edit weight, and remove weight menu
items. The add weight context menu item enables the user to enter a
new weight measurement to the weight table 616. When the user
selects this menu item, the program presents the weight entry form
648 illustrated in FIG. 43. A date field 650 defaults to the
current date, and the user may choose a date by selecting the
drop-down menu button associated with the date field 650 and
choosing a date from the drop-down menu. A time field 652 defaults
to the current time, and the user may enter any (properly
formatted) time value. A weight field 654 is left blank for the
user to fill in, and an MRN field 656 is filled in by the program
with the medical record number of the current patient. The MRN
field is read-only and thus cannot be modified by the user. An
account number field 658 is also read-only, and contains the
account number of the currently-selected visit. When the user has
completed the form 648, he or she saves the information by
selecting the save button or discards the information by selecting
the cancel button. There is typically one weight recorded for a
twenty-four hour period, although the program enables the user to
submit patient weight information at any frequency.
[0215] The edit weight menu item of the weight context menu 646
enables the user to change a previously submitted weight
measurement. This menu item is row specific, so the user must
select a specific row of the weight tab 616 before activating the
context menu 646 and choosing this item. When the user has selected
a row and chosen the edit weight context menu item, the program
presents the weight entry form 648, described above, populated with
the data from the selected row of the weight table 616. The user
can then modify one or more of the date 650, time 652, and weight
654 fields and save or discard the information as explained
above.
[0216] The remove weight menu item of the weight context menu 646
enables the user to remove a previously submitted weight record
from the weight table 616. This menu item is row specific, so the
user must choose a row of the table 616 before activating the
context menu 646 and choosing this item. When the user selects a
row and chooses the remove weight menu item, the program requests a
confirmation from the user in a conventional manner and removes the
row of information from the table 616 if the user confirms the
removal request.
[0217] The maximum temperature table 618 lists all patient
temperatures recorded during a particular patient visit in reverse
chronological order. There is one row of information in the table
618 for each recorded temperature, and each row is divided into
several columns. A date/time column provides the date and time the
temperature was measured, and a temperature column indicates a
measured temperature in degrees Celsius.
[0218] A maximum temperature table context menu 660 presents three
context menu items, including add temperature, edit temperature,
and remove temperature menu items. The add temperature context menu
item enables the user to enter a new temperature measurement to the
maximum temperature table 618. When the user selects this menu
item, the program presents the temperature entry form 662
illustrated in FIG. 44. A date field 664 defaults to the current
date, and the user may choose a date by selecting a drop-down menu
and choosing a date from the drop-down menu. A time field 666
defaults to the current time, and the user may enter any (properly
formatted) time value. A temperature field 668 is left blank for
the user to fill in, and an MRN field 670 is filled in by the
program with the medical record number of the current patient. The
MRN field 670 is read-only and thus cannot be modified by the user.
An account number field 672 is also read-only, and contains the
account number of the currently-selected visit. When the user has
completed the form 662, he or she saves the information by
selecting the save button or discards the information by selecting
the cancel button. Typically the highest temperature for a
twenty-four hour period is recorded, although the program enables
the user to submit patient temperature information at any
frequency.
[0219] The edit temperature item of the maximum temperature context
menu 660 enables the user to change a previously submitted
temperature measurement. This menu item is row specific, so the
user must select a specific row of the maximum temperature table
618 before activating the context menu 660 and choosing this item.
When the user has selected a row and chosen the edit temperature
context menu item, the program presents the temperature entry form
662, described above, populated with the data from the selected row
of the maximum temperature table 618. The user can then modify one
or more of the date 664, time 666, and temperature 668 fields and
save or discard the information as explained above.
[0220] The remove temperature item of the maximum temperature
context menu 660 enables the user to remove a previously submitted
temperature record from the maximum temperature table 618. This
menu item is row specific, so the user must choose a row of the
table 618 before activating the context menu 660 and choosing this
item. When the user selects a row and chooses the remove
temperature menu item, the program requests a confirmation from the
user in a conventional manner and removes the row of information
from the table 618 upon receiving a user confirmation.
The Reports Tab
[0221] The reports tab 414 is illustrated in FIG. 45 and contains a
list of reports from various departments associated with the
selected visit and patient. These reports are typically text-based
electronic documents and clinical evaluations. The reports are
stored in the hospital information system (HIS), and the program
enables the user to select and view the documents via a user
interface generated by the program. The reports tab 414 presents
two nested tabs, including a general information tab 674 and a
report tab 676.
[0222] The general information tab 674 includes a table 678 of
reports that can be displayed according to department or report
date. When the user selects a department radio button 680 an
associated drop-down menu 682 provides a list of all departments
that have provided one or more reports for the selected patient's
visit. When the user selects a department from the department
drop-down menu 682, the table 678 displays a list of all reports
provided by the selected department during the patient's visit.
[0223] When the user selects a report date radio button 684, an
associated drop-down menu 686 provides a list of all dates in which
reports were generated. When the user selects a particular date
from the date drop-down menu 686, the table 678 displays a list of
all reports provided on the selected date. The user views a
particular report by selecting the report from the list of reports
in the table 678, activating a context menu 688, and selecting a
view selected report menu item. This causes the reports tab 414 to
switch to the nested report tab 676 which displays the selected
report, as illustrated in FIG. 46.
The Discharge and Follow Up Tabs
[0224] The discharge tab 416 presents patient information
associated with the discharge of the patient from the hospital, and
the follow up tab presents patient information associated with
follow up visits or contacts with the patient. The information in
these tabs may be presented in a manner similar to that of the tabs
described above.
The Research View
[0225] Referring to FIG. 47, the research view presents a top-level
interface 700 that enables users to set up and manage research
studies. The interface 700 allows only users with the role of
system administrator to enter or change data associated with the
management of research studies. Each member of a study, however, is
allowed to submit information pertaining to that study. The
interface 700 is launched when the user selects an add new study
menu item of the study menu, as explained below. The illustrated
research view interface 700 includes various tabs, wherein each tab
relates to a separate interface element. The tabs include study
setup 702, members 704, patients 706, comments 708, and parameters
710 tabs.
[0226] The study setup tab 702 is illustrated in FIG. 47 and
presents a research form for setting up a new research study. A new
research study must be set up and saved before research team
members can be added, patients can be enrolled, or any other
detailed information can be submitted about the study. The study
setup tab 702 provides general information about the study. A study
type drop-down menu 712 presents various study type options,
including quality assurance/quality improvement (QA/QI), clinical
program, research exempt, and research non-exempt menu items. A
study status drop-down menu 714 presents various study status
options, including active, inactive, pending, and closed menu
items. An enrollment status drop-down menu 716 presents various
enrollment options, including active, inactive, and closed. The
study type 712, study status 714, and enrollment status 716
drop-down menus are required data fields, therefore the user must
choose an item from each of these menus to set up a new study.
[0227] A section labeled "IRB Detail" 718 includes various data
fields for receiving institutional review board (IRB) information
if the research study has IRB approval. Within the IRB detail
section 718 is a subject identifiers section 720 which defines what
patient-specific information can be provided on reports. If all
patient information can be provided, the user selects an "All"
radio button 722. If no patient information can be provided, the
use selects a "None" radio button 724. If only certain pieces of
patient information can be provided, the user selects a "Some"
radio button 726 and then checks the specific pieces of information
that will be provided in a list 728 of possible pieces of
information. A section titled "Project Info" 730 and a section
titled "Project Detail" 732 each include various data fields for
receiving information specific to the project. The user stores the
submitted information and closes the window by selecting the save
button, or discards the information and closes the window by
selecting the cancel button.
[0228] The members tab 704 is illustrated in FIG. 48, wherein the
tab generally presents a list of members of a study and enables the
user to add and remove study members. Only designated members of a
study may view study information or enter patient study data. Users
must have a system user account and must be added to the study by a
system administrator to become members of a selected study. As
illustrated in FIG. 48, the members tab 704 presents a table 734 of
members of the study along with various pieces of information
pertaining to each member. A user name column 736 presents the
study member's name; a primary investigator column 738 presents a
checkbox that is checked if the member is a primary investigator of
the study; a coordinator column 740 presents a checkbox that is
checked if the member is a study coordinator; a sub-investigator
column 742 presents a checkbox that is checked if the member is a
study sub-investigator; and an inactive column 744 presents a
checkbox that is checked if the member is no longer an active
member of the study.
[0229] A context menu 746 is associated with the table 734 and
includes two menu items: an "Add A Member to This Study" menu item
and a "Delete This Member from the Study" menu item. When the user
selects the "Add A Member to This Study" menu item the program
presents a new study member form 748 illustrated in FIG. 49. Using
the form 748, the user scrolls through a list of system users and
adds a user to the study by selecting the user and then selecting
an ok button. Newly-added study members are given the default role
of sub-investigator, but the user can change the member's role by
selecting another role from the possible check boxes in the table
734 of study members.
[0230] To delete a member from the list of study members, the user
must first select the member from the table 734 of study members
and then activate the context menu 746. When the context menu 746
appears, the user selects the "Delete This Member from the Study"
menu item. The program requests a confirmation from the user in a
traditional manner, and when the user confirms the request the
program removes the selected member from the study and from the
study members table 734. If the user desires to maintain a record
that a particular member was part of the study at one time, the
user checks the appropriate box in the inactive column 744 as
opposed to deleting the member entirely from the study.
[0231] The patients tab 706 is illustrated in FIG. 50, wherein the
patients tab 706 generally enables the user to add and remove
patients from a study, and to update study patient information. The
tab 706 presents a study patients table 750 with one or more rows
of information, wherein each row includes information about a
particular patient. Once a patient is added to a study, that
patient is assigned a non-traceable patient identification number
752. The program only allows a system administrator to refer back
to a study patient's identification information, such as name and
medical record number, after enrollment in a research study. In
addition to the identification number 752, each row of patient
information includes an enrollment date 754, which is the date the
patient was enrolled in the study; an inactive checkbox 756, which
is checked if the patient is no longer active in the study; an
excluded checkbox 758, which is checked if the patient has been
excluded from the study after enrollment; and an expired checkbox
760, which is checked if the patient has expired after enrollment
in the study.
[0232] A patients context menu 762 presents four menu items that
are related to the study patients table 750, and generally enable
the user to enroll patients in and remove patients from the study,
change patients' enrollment date, and view patient identifiable
information.
[0233] An "Add A Patient To This Study" menu item 764 enables the
user to enroll a patient in a research study. When the user selects
this menu item 764, the program presents a patient search form as
illustrated in FIG. 57. The patient search form receives one or
more search parameters from the user and performs a search of the
entire patient database according to the one or more parameters.
The user selects a patient from a list of patients, then selects an
open button to enroll the selected patient to the study. When the
user selects a patient, the program assigns the non-traceable
identification number 752 to the patient. Once the patient is
enrolled in the program, the user can change the patient's status
by selecting one of the status checkboxes 756,758,760. The patient
search form may also be launched from the menu toolbar 56, as
explained below.
[0234] A "Delete This Patient From The Study" menu item 766 enables
the user to remove a patient from the research study. The user must
select a patient listed in the study patient table 750 before
activating the context menu 766 and selecting this menu item 766.
When the user requests that a specific patient be removed from the
research study, the program presents a confirmation request (not
shown) in a conventional manner. If the user confirms the removal
action, the program removes the patient from the study and from the
study patients table 750. If the user desires to maintain a record
that a patient was previously an active study member, the user
selects an appropriate status checkbox 756,758,760 as opposed to
removing the patient from the study.
[0235] A "Change Enroll Date for This Patient" menu item 768
enables the user to change the date on which patients are enrolled
in the study. When the user selects this menu item 768, the program
presents a change enrollment date form 770 as illustrated in FIG.
51. The user changes the patient's enrollment date by entering a
new date in a date field 772 and selecting the okay button. The
enrollment date of the selected patient is then updated in the
study patients table 750.
[0236] A "View Study Patient Information" menu item 774 enables the
user to view identification information of study patient. As
explained above, when a patient is enrolled in a study the program
assigns the patient a non-traceable identification number 752 for
privacy purposes. When the user selects the "View Study Patient
Information" menu item 774 the program retrieves and presents the
patient's actual identification information. This is the only way
for the user to trace a patient identification number 752 to a
particular patient. When the user selects this menu item 774, the
program presents a study patient information form 776 as
illustrated in FIG. 52. The form 776 associates the anonymous
identification number 752 of each patient enrolled in the study
with the patient's actual medical record number 778, name 780, and
study enrollment date 782. The program allows only users with the
role of system administrator to select this menu item 774 and view
the form 776.
[0237] The comments tab 708 is illustrated in FIG. 53, wherein the
tab 708 generally receives, logs, and tracks action items, issues,
and responsibilities associated with a study. The tab 708 presents
a comment table 784 with several rows of information, wherein each
row relates to a particular comment and includes various columns of
information. A date column 786 indicates the date on which the
study comment was logged; a comment column 788 presents a
description of the study comment or item; a status column 780
provides a status of the comment or item such as completed, pending
or on hold; a responsible column 782 provides the name of the user
designated as primarily responsible for the comment or item; and a
priority column 784 lists the relative priority of the comment or
item, such as low, mid, or high.
[0238] A study comments context menu 796 generally enables users to
add new comments, edit existing comments, and remove comments. When
the user selects an "Add New Comment" menu item 798 the program
presents a new comment form 800 as illustrated in FIG. 54. The new
comment form 800 presents several data fields for receiving
detailed information about the comment from the user. A date
drop-down menu 802 indicates a date on which the comment was logged
or the issue was submitted by the user, wherein the user may type
the date directly into the menu field or choose a date from a
drop-down menu. The user chooses a status of the comment or issue
by selecting a status option from a status drop-down menu 804,
wherein the menu items (not shown) include completed, pending, and
on-hold. The user indicates a priority of the comment or issue by
selecting a priority option from a priority drop-down menu 806,
wherein priority options include low, mid, and high.
[0239] A responsible drop-down menu 808 of the new comment form 800
enables the user to indicate a user who is primarily responsible
for the comment or issue. The user may do so in either of two ways:
first, the user may type the name of a user directly into the
field; second, the user may select the button 810 labeled ". . . "
to invoke the form 748 illustrated in FIG. 49 and choose a user via
the form 748. In the comments field 812 the user types any comment,
issue, status description, etcetera. This entry is displayed as the
comment 788 in the study comments table 784. The user closes the
form and stores the form data by selecting the save button, or
closes the form without saving any of the information by selecting
the cancel button.
[0240] When the user selects the "Edit Selected Comment" menu item
814 the program presents the new comment form 800 illustrated in
FIG. 54 and described above. Before selecting this menu item 814,
however, the user must select a row of information in the study
comments table 784. The program presents the form 800 populated
with comment information from the selected row. The user may then
update any of the fields of the form 800 and store the saved
information by selecting the save button.
[0241] A "Remove Selected Comment" menu item 816 enables the user
to delete an entire row of information from the study comments
table 784. To delete a row of information from the table 784, the
user selects the row, activates the context menu 784, and selects
this menu item 816. When the user requests that a specific row of
information be removed from the table 784, the program presents a
confirmation request (not shown) in a conventional manner. If the
user confirms the removal action, the program removes the row of
information from the table 816.
[0242] The parameters tab 710 is illustrated in FIG. 55 and enables
the user to configure research study specific information for entry
into the program's database. Research studies often require special
information to be recorded that is not part of the research dataset
described above. An example of such information is specific family
medical history information or other data that is required for the
research study but that is not part of the patient's normal medical
information. The parameters tab 710 enables users to build a custom
form for a study and define the data fields, controls, and
questions that will appear on the form. This custom form can then
be accessed via the studies tab 310 of the patient view interface
310.
The Menu Toolbar
[0243] The menu toolbar 56 is presented as part of one or more of
the views described above and generally presents the same set of
menus in each view. The menu toolbar is presented as part of the
department view interface 34, the patient view interface 300, and
the visit view interface 400. Particular reference will be made to
the menu toolbar 56 as illustrated in FIG. 56 as part of the
department view interface 34, with the understanding that when
presented as part of other interfaces, the toolbar performs
substantially the same function.
[0244] The patient menu 900 of the menu toolbar 56 includes a
patient lookup 902 menu item. When the user selects the patient
lookup menu item 902 the program presents a patient search form 904
as illustrated in FIG. 57. The patient search form 904 enables the
user to search for a patient or group of patients according to one
or more search parameters, select a patient, and open the patient
view for the selected patient. The illustrated form 904 includes
two search parameters fields: medical record number 906 and patient
name 908. The user may submit a portion of a name, such as the
first one, two, or three letters of the last name, and program will
retrieve all patients who last names begin with the submitted
letter or letters. If the user submits both a medical record number
and a search name, the program will only search for the patient
medical record number.
[0245] The form 904 presents search results in the form of a search
result table 910 comprising one or more rows of patient
information. Each row pertains to a single patient, and the rows
are divided into columns for the patient's medical record number,
name, birth date, and sex. A search button initiates a search of
the program database according to one or both of the search
parameters 906,908; an open button opens the patient view of a
patient selected from the patient search results table 910; and a
not found button opens an HIS search form (not shown), which allows
the user to search the HIS 20b for information about the patient.
If the patient is found in the HIS 20b, the user then has the
option to view visits, verify that the patient is the one being
sought, and extract patient information from the HIS 20b to the
local database 20e.
[0246] The studies menu 912 of the menu toolbar 56 is associated
with the research view, described above. The studies menu presents
four menu items, including new study 914, edit study 916, view my
studies 918, and view all studies 920.
[0247] The add new study menu item 914 can be selected only by a
user with the role of system administrator. When the user selects
this menu item, the program presents a blank new research form 700,
illustrated in FIG. 47. The process of setting up a new research
study using the form 700 is described in detail above.
[0248] The edit study menu item 916 also can only be selected by a
user with the role of system administrator. When the user selects
this menu item 916, the program presents a study list form 922 as
illustrated in FIG. 58. The user selects a study from the list of
studies presented in the form 922, and selects an open button to
display the research study form 700. The user can then edit study
information via the research study form 700.
[0249] The view my studies menu item 918 can be selected by any
user, and causes the program to present the study list form 922
illustrated in FIG. 58. However, when the user invokes the study
list form 922 via the view my studies menu item 918, the form 922
only includes studies of which the user is a member. The user can
then select a particular study and select the open button to invoke
the research study form 700 to view information relating to the
study. The study information will be read-only, such that the user
will not be able to modify information contained therein.
[0250] The view all studies menu item 920 can be selected by any
user and causes the program to present the study list form 922
illustrated in FIG. 58, wherein the form 922 presents a list of all
research studies, irrespective of the user's membership in any
study. When the study list form 922 is invoked via the view all
studies menu item 920, the user cannot retrieve any further
information about a particular study, but is limited only to
viewing the list of studies presented in the form 922.
[0251] The charts menu 924 of the menu toolbar 56 enables the user
to create charts of various pieces of information that are used by
physicians and other care givers to correlate and evaluate leading
indicators, events, interventions, and results. This is
accomplished by charting events and interventions on the same
graphs as indicators and results are charted. The charts menu 924
includes menu items select events to chart 926, create chart with
normal range 928, and create multiple value run chart 930.
[0252] The select events to chart menu item 926 enables the user to
select one or more events from a plurality of events to chart on a
graph concurrently with one or more indicators or results. FIG. 59
provides an exemplary chart 932 with complications, procedures and
pulmonary events charted on the same graph 934 as hematology lab
results. Various milestone points 936 are plotted along the bottom
of the graph 934, wherein the milestone points 936 are preferably
presented in different colors. A legend 938 within the chart 932
defines these points to be complications, procedures, and pulmonary
events according to color. Each milestone point 936 represents an
exact time that a corresponding event occurred relative to the
hematology lab results. Thus, a user can quickly and easily
correlate a particular hematology lab result--or a group of
results--to a particular complication, procedure, or both.
[0253] The chart 932 also enables the user to quickly review the
details of each complication, procedure and pulmonary event
represented by the milestone points 936. The user does this by
placing an on-screen pointer or cursor over a particular milestone
936, wherein the program displays a description 940 of the event.
In the illustrated example, the user can quickly and easily infer
that there is a relationship between a sudden drop in platelets 942
and the hematological event 944 of bleeding requiring
operation.
[0254] When the user selects the select events to chart menu item
926 the program presents a select events to chart form 946,
illustrated in FIG. 60. The events that will be charted correspond
to the selected categories for a patient as described above in
relation to the events nested tab 510 of the post operative tab 412
of the visit view interface 400, as illustrated in FIG. 39. The
user selects one or more of the event categories from the form 946
to include in the chart 932 and selects an okay button to apply the
selection or selections. Events from the selected event categories
948 are then charted in all graphs that the program presents. The
user may discontinue this function by selecting the select events
to chart menu item 926 and deselecting any event categories 948
that were previously selected.
[0255] The create chart with normal range menu item 928 enables the
user to compare a patient's laboratory test results to normal test
values. Many laboratory results are communicated from the
laboratory with values that the laboratory considers to be normal
ranges for a particular patient's age, weight, and other
factors--collectively referred to herein as the patient profile.
The program is operable to graph each numeric laboratory result
type that is returned with the normal range when the user selects
the create chart with normal range menu item 928. An exemplary
chart 950 with a normal range indicator 952 is illustrated in FIG.
61. The chart 950 depicts the patient's blood chemistry potassium
level (K) against the normal range as determined by the lab for
patients with similar characteristics. The normal range indicator
952 is a shaded region that enables the user to quickly and easily
compare the patient's actual measured potassium level 954 with the
normal range over a period of time, such that a physician can
quickly determine when and by how much the patient's potassium
level was abnormally high and abnormally low. Events and
interventions, as described above, can also be plotted in a normal
range chart.
[0256] When the user selects the create chart with normal range
menu item 928, the program presents a range chart selection form
956 as illustrated in FIG. 62. The user selects a type of test from
a test type drop-down menu 958, which limits the options in a lab
value to chart drop-down menu 960 to only those associated with the
selected test type. The user then selects the lab value to be
charted from the lab value to chart drop-down menu 960. The program
then generates a chart, such as chart 950, with the selected test
result in normal range.
[0257] A table of numeric lab tests is presented in FIG. 63,
wherein each lab test is associated with a test type 962, a first
indicator 964 indicating whether a range chart may be generated for
the test, and a second indicator 966 indicating whether a multiple
value run chart may be generated for the test.
[0258] A multiple value run chart plots lab results of different
types on a single graph. An exemplary multiple value run chart 968
is illustrated in FIG. 64, which simultaneously plots two blood gas
lab results--HCO3 and PCO2, one chemistry lab result--CO2, and two
hematology test results--WBC and Hgb. The program can include any
numeric lab result in a multiple value run chart, and can
simultaneously plot up to five lab results of different lab
types.
[0259] A normalize button 970 below the chart 968 enables the user
to normalize the plotted values to more easily depict relationships
between lab results. When the user selects the normalize button 970
the program eliminates disparities between lab test values by
recalculating each as a relative change around a value of one. This
result is illustrated in FIG. 65. The normalized chart 972 is
especially helpful for simultaneously plotting lab values that are
quite different, such as ph results, where a normal result may be
7.4, but a platelet result is typically around 300. Events and
interventions, explained above, can also be displayed
simultaneously in a normalized chart.
[0260] When the user selects a create multiple value run chart menu
item 930, the program presents a run chart selection form 974
illustrated in FIG. 66. To chart up to five lab results on a single
graph, the user selects a first test type from a first test type
drop down menu 976 and a corresponding lab result from a first lab
value drop-down menu 978; a second type from a second test type
drop down menu 980 and a corresponding lab result from a second lab
value drop-down menu 982; and so forth up to a fifth type from a
fifth test type drop down menu 984 and a corresponding lab result
from a fifth lab value drop-down menu 986. Once the user has
selected two or more test types and lab values, he or she selects a
view chart button 988 to cause the program to present the chart
including the selected test results.
[0261] The reports menu 990 presents one or more reports menu items
(not shown) that, when selected, generated reports relating to the
other aspects of the program such as, for example, the rounds
report 168 illustrated in FIG. 9.
[0262] The options menu item 78 enables the user to choose one or
more options associated with program, such as the lab lookback
period. When the user chooses a lab lookback period menu item 992
of the options menu 78, the program generates a lab lookback form
994 as illustrated in FIG. 67. The form 994 allows the user to
determine the number of days back labs are viewed when any view
current clinical data items are selected. A default lookback period
is seven days, but the user can change the lookback period to any
integer value. If the user selects a set as default checkbox 996,
the value currently listed in the lookback data field 998 becomes
the default lookback period. If the set as default checkbox 996 is
not selected, the lookback value 998 is only used for the current
session.
* * * * *